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Revista médica de Chile

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MARTINEZ S, Alejandro et al. Hyperuricemia as a marker for anaerobic threshold in chronic cardiac failure. Rev. méd. Chile [online]. 2001, vol.129, n.5, pp.503-508. ISSN 0034-9887.

Background: Patients with chronic cardiac failure often have elevated plasma uric acid levels, that are associated to a dismal prognosis. Aim: To investigate possible metabolic mechanisms to explain elevated uric acid levels in these patients. Patients and methods: Eighteen patients with chronic cardiac failure aged 61 ± 10 years old, without gout or renal failure and not using high doses of diuretics (equal or less than 80 mg/day furosemide or 50 mg/day hydrochlorothiazide) were studied. Plasma uric acid levels were correlated with anaerobic threshold, maximal oxygen uptake, plasma noradrenaline and creatinine and left ventricular ejection fraction, measured radioisotopically. Results: Mean maximal oxygen uptake was 16.6 ± 4.2 ml/kg/min. There was a negative correlation between uric acid levels and maximal oxygen uptake or maximal oxygen uptake/body surface area (r=0.521 and -0.533 respectively, p<0.05). Patients with uric acid levels over 7 mg/dl had a lower anaerobic threshold than patients with lower levels (9.81 ± 2.41 and 13.08 ± 3.28 ml/kg/min respectively, p<0.05). No significant differences in maximal oxygen uptake were observed in these two groups of patients (15.5 ± 4.24 and 18.08 ± 3.86 ml/kg/min respectively). Uric acid levels did not correlate with plasma noradrenaline, creatinine or lefi ventricular ejection fraction. Conclusions: These results suggest that a defect in cellular oxygenation contributes to the elevation of plasma uric acid levels in patients with chronic cardiac failure. (Rev Méd Chile 2001; 129: 503-8)

Keywords : Anoxia; Cardiac output, low; Oximetry; Oxygen; Uric acid.

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