Abstract 12596: Uric Acid Increases the Incidence of Ventricular Arrhythmia in Patients with Left Ventricular Hypertrophy
Backgrounds: Elevated uric acid (UA) level has been considered to be related to the development of cardiovascular diseases including left ventricular hypertrophy (LVH). LVH is associated with enhanced incidence of ventricular arrhythmias and increased risk of sudden cardiac death. However, little is known about the association between UA level and the occurrence of ventricular arrhythmias. Thus, we examined this issue in patients with LVH.
Methods: The study subjects consisted of 167 patients (110 males, mean age 70±8 years) with LVH defined as wall thickness of interventricular septum (IVS) and posterior wall (PW) were greater than 12 mm by echocardiography. The serum UA, potassium, creatinine, total bilirubin and hemoglobin levels were measured. In addition, left ventricular ejection fraction (LVEF) was measured and LV diastolic function was evaluated by deceleration time (DcT) and E/A ratio of the transmitral flow velocity curves by echocardiography. The patients were divided into two groups based on whether ventricular tachycardia (VT) presented (defined by more than 5 beats, group-A, n=27) or not (group-B, n=140) by 24 hour Holter monitoring. We compared these measured parameters between two groups.
Results: Although the potassium, creatinine, total bilirubin and hemoglobin levels did not differ between two groups, the UA level was significantly higher in group-A than in group-B (6.8±1.4 mg/dl vs. 5.4±1.5 mg/dl, P<0.01). The wall thickness of IVS and PW did not differ between two groups (IVS: 13.7±0.3 mm vs. 14.7±0.7 mm NS; PW: 13.4±0.2 mm vs. 14.5±0.8 mm, NS). LVEF, DcT and E/A ratio of the transmitral flow velocity were not different between two groups (LVEF: 59.2±11.1% vs. 60.8±7.6%, NS; DcT: 226±61 ms vs. 233±67 ms, NS; E/A ratio: 0.94±0.10 vs. 0.85±0.09, NS). Multivariate Cox hazard analysis identified UA level as an independent predictive factor for the occurrence of VT (odds ratio 1.95; 95% confidence interval, 1.3–2.8; P<0.01).
Conclusions: The incidence of VT was related to serum UA level, but not with the degrees of LVH, LV systolic and diastolic function. These results suggest that serum UA level is a good marker to predict ventricular arrhythmias in patients with LVH.
- © 2010 by American Heart Association, Inc.