Resumen

MARTINEZ S, Alejandro et al. Prognostic value of hyperuricemia in chronic heart failure. Rev. méd. Chile [online]. 2004, vol.132, n.9, pp. 1031-1036. ISSN 0034-9887.  doi: 10.4067/S0034-98872004000900002.

Background: Hyperuricemia has been proposed as a risk marker in chronic heart failure, but its value as an independent prognostic is not well established. Aim: To determine the prognostic value of hyperuricemia, in patients with chronic stable heart failure. Patients and methods: Forty six male patients with chronic heart failure, aged 62±13 years, were studied. Their ejection fraction was less than 40% and their serum creatinine was less than 2 mg/dl. Serum uric acid and catecholamines, maximal oxygen consumption (VO₂ max) and left ventricular ejection fraction were measured. Mortality and the need for cardiac transplant were recorded as endpoints during a mean follow up of 39±18 months. The relationship between basal measures and the occurrence of events was analyzed using univariate and multivariate methods. Results: Basal VO₂ max and left ventricular ejection fraction were 16±4.6 ml/kg/min and 22±7% respectively. Eighteen patients died and three required transplantation during the follow up. Patients reaching these endpoints had a lower VO₂ max and left ventricular ejection fraction and higher uric acid levels. Multivariate analysis accepted left ventricular ejection fraction (relative risk 0.89, 95% CI 0.82-0.97) and serum uric acid (relative risk 1.335 95% CI 1.02-1.74) as significant predictors of events. The relative risk for cardiac transplantation was 7.07 times higher among those with a serum uric acid over 7 mg/dl. Conclusions: A high serum uric acid is an independent predictor of bad prognosis in patients with stable chronic heart failure (Rev Méd Chile 2004; 132: 1031-6

Palabras clave : Heart failure; congestive; Hyperuricemia; Stroke volume; Ventricular ejection fraction.