title: Evaluation of cardiovascular risk in stages of gout by a complex multimodal ultrasonography.
abstract: The aim of our work was to assess ultrasound features of cardiovascular (CV) risk in stages of gout. Cross-sectional complex multimodal ultrasound study of 169 age-matched patients, with similar distribution of arterial hypertension, diabetes mellitus, obesity and chronic renal failure, was divided into four groups: 41 with asymptomatic hyperuricemia, 52 gout without tophi, 42 gouty tophi and 34 controls with osteoarthritis. Parameters independently associated with CV risk were measured: renal resistive index (RRI), left ventricular mass index (LVMi), mitral annulus early diastolic velocity (e'), intima-media thickness (IMT) and common carotid artery resistive index (CCARI). Multivariate analyses were performed to evaluate the impact of gout stages and CV risk factors on ultrasound alterations. Gouty tophi increased the risk of having IMT >0.90 mm with an OR 11.51 (95 % CI 2.32-57.21, p = 0.003), gout without tophi raised the risk with an OR 6.25 (95 % CI 1.37-28.44, p = 0.018), while asymptomatic hyperuricemia had no effect on IMT. The category of CCARI >0.70 was influenced by tophi with an OR 11.18 (95 % CI 2.61-47.83, p = 0.001) and by arterial hypertension with an OR 3.22 (95 % CI 1.11-9.36, p = 0.032). Neither asymptomatic hyperuricemia nor gout without tophi modified the development of abnormally high CCARI. Gout stages had no impact on LVMi, e' and RRI. Tophi are related to worsened ultrasonographic parameters evaluating target organs in gout, relative to earlier stages of the disease. They create a strong risk of carotid arteries' changes even beyond arterial hypertension.
authors: Department of Internal Medicine, Medical Faculty, Clinic of Rheumatology, Medical University, University Hospital St. Iv. Rilski, 13, Urvich St., 1612, Sofia, Bulgaria. rada_ga@mail.bg.
authors: Rada
authors: R
authors: Gancheva
authors: Department of Internal Medicine, Medical Faculty, Clinic of Nephrology, Medical University, University Hospital St. Iv. Rilski, 15, Iv. Geshov St., 1431, Sofia, Bulgaria.
authors: Atanas
authors: A
authors: Kundurdjiev
authors: Department of Internal Medicine, Medical Faculty, Clinic of Rheumatology, Medical University, University Hospital St. Iv. Rilski, 13, Urvich St., 1612, Sofia, Bulgaria.
authors: Mariana
authors: M
authors: Ivanova
authors: Faculty of Public Health, Medical University, 8, Bialo more St., 1527, Sofia, Bulgaria.
authors: Todor
authors: T
authors: Kundurzhiev
authors: Department of Internal Medicine, Medical Faculty, Clinic of Rheumatology, Medical University, University Hospital St. Iv. Rilski, 13, Urvich St., 1612, Sofia, Bulgaria.
authors: Zlatimir
authors: Z
authors: Kolarov
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D005260:Female; D006073:Gout / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D014463:Ultrasonography / Q000379:methods
keywords: CV risk; Complex multimodal ultrasonography; Gout stages