Elevated uric acid levels: a predictor of pulmonary hypertension
DOI:
https://doi.org/10.18203/2349-3933.ijam20162202Keywords:
Elevated uric acid, Pulmonary hypertension, Predictor, Pulmonary arterial pressureAbstract
Background: Pulmonary hypertension is a chronic, progressive and a fatal disease. Uric Acid is elevated in case of myelo and lymphoproliferative diseases, decreases uric acid excretion or as a part of metabolic syndrome (insulin resistance). It is also said to be associated in patients with heart failure leading to severe symptoms and fatality. This study was conducted to identify if elevated uric acid levels can be a predictor of pulmonary hypertension.
Methods: After taking the detailed demographic data of 62 patients, a thorough clinical and physical examination, postero-anterior chest X-rays, pulmonary function testing, ventilation or perfusion scintigraphy and Electro Cardiograph was also done for all the patients. Blood was drawn for testing uric acid, creatinine and total bilirubin levels.
Results: Out of the 62 patients, 43.5% were males and 56.5% were females. Out of the NYHA classes, most of the patients 58% belonged to the Class II, 34% to class III and 8% to Class IV. . The total bilirubin and creatinine levels were higher in patients with hyperuricemia than that of the controls. The blood saturation levels were significantly lower with only 67% and heart rate was on average more than 89 beats per minute. A positive correlation with NYHA class and MPAP, and a negative correlation with LVEF and RVEF were observed.
Conclusions: In conclusion, the results of this study establish that hyperuricemia is common in patients with severe PH.
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References
Van Albada ME, Loot FG, Fokkema R, Roofthooft MT, Berger RM. Biological Serum Markers in the Management of Pediatric Pulmonary Arterial Hypertension. Pediatric Research. 2008;63:321-7.
Fox IH. Metabolic basis for disorders of purine nucleotide degradation. Metabolism.1981;30:616-34.
Leyva F, Anker S, Swan JW, Godsland IF, Wingrove CS, Chua TP, et al. Serum uric acid as an index of impaired oxidative metabolism in chronic heart failure. Eur Heart J. 1997;18:858-65.
Hayabuchi Y, Matsuoka S, Akita H, Kuroda Y. Hyperuricemia in cyanotic congenital heart disease. Eur J Pediatr. 1999;152(11):873-6.
Hasday JD, Cyril M. Grun "nocturnal increase of urinary uric acid: creatinine ratio". American Review of Respiratory Disease. 1987;135(3):534-8.
Braghiroli A, Sacco C, Erbetta M, Ruga V, Claudio F. Donner"overnight urinary uric acid: creatinine ratio for detection of sleep hypoxemia: validation study in chronic obstructive pulmonary disease and obstructive sleep apnea before and after treatment with nasal continuous positive airway pressure", American Rev Respir Dis. 1993;148(1):173-8.
Elsayed NM, Nakashima JM, Postlethwait EM. Measurement of uric acid as a marker of oxygen tension in the lung. Arch Biochem Biophys Arch Biochem Biophys. 1993;302(1):228-32.
Hughes JD, Rubin LJ. Primary pulmonary hypertension: an analysis of 28 cases and a review of the literature. Medicine (Baltimore). 1986;65(1):56-72.
Rich S, Dantzker DR, Ayres SM, Bergofsky EH, Brundage BH, Detre KM, et al. Primary pulmonary hypertension: a national prospective study. Ann Intern Med. 1987;107(2):216-23.
Rich S. Primary pulmonary hypertension. Prog. Cardiovasc. 1988;31(3):205-38.
Higenbottam T, Stenmark K, Simonneau G. Treatments for severe pulmonary hypertension, Lancet. 1999;353:338-9.
Rubin LJ. Primary pulmonary hypertension. N Engl J Med. 1997;336:111-7.
Chun-Yan Z, Long-Le M, Le-Xin W. Relationship between serum uric acid levels and ventricular function in patients with idiopathic pulmonary hypertension. Exp Clin Cardiol. 2013;18(1):e37-9.
D'Alonzo GE, Barst RJ, Ayres SM, Bergofsky EH, Brundage BH, Detre KM, et al. Survival in patients with primary pulmonary hypertension. Results from a national prospective registry. Ann Intern Med. 1991;115:343-9.
Chapman PJ, Bateman ED, Benatar SR. Prognostic and therapeutic considerations in clinical primary pulmonary hypertension. Respir Med. 1990;84:489-94.
Sandoval J, Bauerle O, Palomar A, Gomez A, Martinez-Guerra ML, Beltran M, Guerrero ML. Survival in primary pulmonary hypertension. Validation of a prognostic equation. Circulation. 1994;89:1733-44.
Voelkel MA, Wynne KM, Badesch DB, Groves BM, Voelkel NF. Hyperuricemia in Severe Pulmonary Hypertension. Chest. 2000;117(1):19-24.
Nagaya N, Uematsu M, Satoh T, Kyotani S, Sakamaki F, Nakanishi N, et al. Serum uric acid levels correlate with the severity and the mortality of primary pulmonary hypertension. Am J Respir Crit Care Med. 1999;160:487-92.
Ross EA, Perloff JK, Danovitch GM, Child JS, Canobbio MM. Renal function and urate metabolism in late survivors with cyanotic congenital heart disease. Circulation. 1986;73:396-400.
Khosla UM1, Zharikov S, Finch JL, Nakagawa T, Roncal C, Mu W, et al. Hyperuricemia induces endothelial dysfunction. Kidney Int. 2005;67:1739-42.
Mercuro G1, Vitale C, Cerquetani E, Zoncu S, Deidda M, Fini M, et al. Effect of hyperuricemia upon endothelial function in patients at increased cardiovascular risk. Am J Cardiol. 2004;94:932-5.
Bendayan D, Shitrit D, Ygla M, Huerta M, Fink G, Kramer MR. Hyperuricemia as a prognostic factor in pulmonary arterial hypertension. Respir Med. 2003;97:130-3.