Abstract 14448: Serum Uric Acid is an Independent Risk Factor for Subclinical Cardiac Dysfunction: A Speckle-Tracking Analysis of the HyperGEN Study

Abstract

Introduction: Increased serum uric acid has been associated with adverse cardiovascular events, but its effects on myocardial function have not been well studied. We hypothesized that increased serum uric acid would be associated with abnormal cardiac mechanics in the HyperGEN study, a large, population-based study of hypertension.

Methods: We performed speckle-tracking analysis on the echocardiograms of HyperGEN participants with normal LVEF (N=1346). Global longitudinal, circumferential, and radial strain (GLS, GCS, and GRS, respectively), and early diastolic (e’) tissue velocities were measured. We used multi-level mixed-effects linear regression (thereby accounting for relatedness among subjects in HyperGEN) to determine whether serum uric acid is independently associated with abnormal cardiac mechanics.

Results: The mean age of the HyperGEN cohort was 55±12 years, 58% were female, 35% were black, 73% were hypertensive, and 12% had chronic kidney disease (GFR < 60 mL/kg/min). On univariate analysis, elevated serum uric acid was associated with decreased GLS and e’ velocities (P<0.001 for all comparisons; see Figure) but not GCS or GRS. After adjusting for age, sex, study site, image quality, systolic blood pressure, GFR, wall motion abnormalities, LV mass index, and EF, serum uric remained associated with reduced GLS (P<0.0001; see Figure) and e’ velocity (P=0.04).

Conclusions: Elevated serum uric acid is independently associated with subclinical longitudinal systolic and diastolic dysfunction. The relationship between elevated serum uric acid and adverse cardiovascular events may be mediated by abnormal cardiac mechanics, eventually resulting in overt cardiac dysfunction.