The Study Of Association Of Serum Uric Acid Level With Left Ventricular Mass And QRS Duration In Patients With Chronic Heart Failure

Objective:To investigate the association of serum uric acid (UA) level with ventricular hypertrophy, ventricular remodeling, and ventricular electromechanical activity dyssynchrony in patients with chronic heart failure by studying the correlation among Left ventricular mass index (LVMI), QRS duration (QRSd) and UA. Methods:Six hundred and eleven cases of patients with chronic heart failure in our hospital between December 2012and October 2014 were analysed retrospectively. Of six hundred and eleven patients with heart failure, eventually four hundred and fifty-three were selected in this study accorded with inclusion and exclusion criteria. The patients in this study included 368 men (mean age 60.64±12.20 yearsold) and 85 women (mean age 60.55±12.67 years old). According to the different UA level, the patients were divided into five groups:group Ⅰ, UA≤360mmol/L; group Ⅱ, 360mmol/L<UA≤420mmol/L; group Ⅲ,420mmol/L<UA≤480mmol/L; group Ⅳ, 480mmol/L<UA≤540mmol/L; group Ⅴ, UA> 540mmol/L. Each patient received examinations of echocardiography、electrocardiogram(ECG)、blood routine and blood biochemistry. All data were input by using EXCEL software and were analyzed by using SPSS 17.0 software for statistical analysis. The value of P< 0.05 was considered significant for all tests. The differences in five groups were compared and the correlation among LVMI, QRSd and UA were analyzed by linear correlation and multiple linear stepwise regression. Results:(1) According to the different UA, from group I to group V, with a progressive increase in UA, LVMI values increased gradually(93.89±30.25g/m2,94.44±32.46g/m2, 101.04±37.22g/m2,124.39±63.22g/m2,133.51±41.85g/m2 respectively).There was significant difference among the five groups(P<0.01). UA level correlated positively with LVMI,r=0.329 (P<0.01). The regression equation obtained by multiple linear stepwise regression was Y (LVMI)=0.118X (UA)+58.56 (P<0.05). (2) According to the different UA, from group I to group V, with a progressive increase in UA, QRSd prolonged gradually(93.10 ±14.56ms,92.77±21.12ms,94.00±19.95,97.55±20.37,101.73±25.57 respectively) (P <0.05), UA level correlated positively with QRSd, r=0.180 (P<0.01). The regression equation obtained by multiple linear stepwise regression was Y (QRSd)=0.028X1 (UA) +83.409 (P<0.05).(3) According to the different UA, from group Ⅰ to group Ⅴ, with a progressive increase in UA, NYHA class increased gradually and LVEF was reduced gradually(P<0.01). NYHA class Ⅲ or class Ⅳ was in patients with higher UA level. Conclusion:The UA level was positively correlated with LVMI in patients with chronic heart failure, as UA level increased, LVMI value increased gradually. It indicated that the rise of UA level maybe reflect the severity of the ventricular remodeling. With the increase of UA level in patients with chronic heart failure, QRSd prolonged gradually, ventricular electrical activity in dyssynchrony was aggravating, ventricular systolic function declined, cardiac function classification increased. It indicated that the rise of UA level maybe reflect ventricular electromechanical activity in dyssynchrony and development of heart failure...