Correlation Between Serum Uric Acid Level And Atrial Fibrillation In Patients With Dilated Cardiomyopathy

Objective: To investigate the relationship between serum uric acid level and atrial fibrillation in patients with dilated cardiomyopathy.Method: we enrolled 283 patients with dilated cardiomyopathy in the first hospital of Nan Ping Affiliated to Fujian Medical University from January 2010 to December 2015. the general conditions,serum biochemistry,NT-pro BNP,ECG and HOTEL of all patients were detected, and LAD, LVDD, LVPW, IVS and LVEF were measured by UCG, then LVMI was Calculated. 1.According to the results of ECG examination, a total of 283 patients was divided into dilated cardiomyopathy with atrial fibrillation group and dilated cardiomyopathy with sinus rhythm group, the data were compared between two groups; 2. According to NYHA heart function classification, the patients divided into NYHAII 75 cases, NYHAIII 107 cases, NYHAIV 101 cases, Correlation between UA, NT-pro BNP and LVEF levels were compared among the groups. 3.According to the different levels of serum uric acid, the four point method was used to divided into First bit array a(n = 70), Second bit array b(n = 70),Third bit array c(n = 72)and Forth bit array d(n = 71),The incidence of atrial fibrillation and cardiac color Doppler index were compared between the four groups.Result : There were sinus rhythm group of 189 cases(of which 131 males(69.3%), female 58 cases(30.7%))and dilated cardiomyopathy with atrial fibrillation group of 94 cases(of which 67 cases were male(71.3%), and 27 cases female(28.7%)) in all patients with dilated cardiomyopathy. The sex ratio, smoking history, drinking history, family history, average heart rate, body mass index, systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, high density lipoprotein cholesterol, low density lipoprotein cholesterol, creatinine, fibrinogen, average heart rate, differences of body weight index and fasting glucose in two groups had no statistically significance(P >0.05);The difference of NT-pro BNP between the two groups was statistically significant(7341.94�4252.02 VS.5581.90�3494.86,P=0.045);Compa red with sinus rhyt hm group, Age (64.31�17.22,55.48�15.07,P=0.005),UA(414.19�131.33,373.83 � 98.35,P=0.004)?LAD(57.90�7.01,49.13�5.96,P=0.007)?LVDD(63.56 � 12.83,59.30 � 11.02,P=0.008)?LVMI(155.55 � 52.00,142.10 � 39.41,P=0.008)were significantly increased and LVEF was Significantly reduced in DCM patients with atrial fibrillation group, the difference were statistically significant(35.40�10.24 VS.41.10�7.69,P=0.007). Logistic regression analysis was showed: Age(OR:1.053;95%CI:1.017~1.085;P=0.002)?UA(OR:1.097; 95%CI:1.054~1.127;P=0.036)?LAD(OR:1.170;95%CI:1.112~1.233; P<0.001) and LVEF(OR:0.937;95% CI:0.912~0.967; P <0.001) were all an independent risk of atrial fibrillation. The risk of atrial fibrillation was increased 5.3% with 1 year, The risk of atrial fibrillation was increased 5.3% with UA1?mol/L, The risk of atrial fibrillation was increased 5.3% with LAD 1mm, The risk of atrial fibrillation was decreased 5.3% with LVEF 1%.2. According to NYHA cardiac function classification, a total of patients was divided into three groups, the number of the patients with NYHA II grade was 75 cases, the number of the patients with NYHA III grade was 107 cases, the number of the patients with NYHA IV grade was 101 cases.UA and NT-pro BNP were Gradually increased in different NYHA cardiac functional groups, LVEF was decreased in different NYHA cardiac functional groups, the differences was statistically significant(P <0.05). 3. According to uric acid levels all patients was devided into dilated cardiomyopathy with hyperuricemia group(n=124) and dilated cardiomyopathy without hyperuricemia(n = 159), two groups of patients occurred in patients with atrial fibrillation were 65 cases(52.4%) and 29 cases(18.2%), the difference was statistically significant(P < 0.01); Four quantile method was divided into four groups:The number of patients with atrial fibrillation in group a, group b, group c, group d were 11 cases, 15 cases, 29 cases, 39 cases respectively and The incidence of atrial fibrillation in the four groups was 15.7%, 21.4%, 40.3% and 54.9% respectively. the difference of the incidence of atrial fibrillation between a VS. b was no statistically significant(P >0.05). the differences of the incidence of atrial fibrillation between(b VS. c)?and(c VS. d) were statistically significant(a15.7% VS. c40.3%;a15.7% VS. d54.9%;b21.4% VS. c40.3%;b21.4% VS. d54.9%;c40.3% VS. d54.9%,P <0.05). Correlation analysis displays as follow: There was a positive correlation between UA and LAD(r=0.456, P<0.01), LVDD(r=0.497, P<0.01) and LVMI(r=0.413, P<0.01),and a negative correlation with LVEF(r=-0.380,P<0.01), the difference was statistically significant;There is no correlation between UA and IVS and LVPW,the difference was no statistically significant(P >0.05).Conclusion: The level of uric acid in dilated cardiomypaehy patients with atrial fibrillation was significantly higher,which may be related to LAD, LVMI,LVDD and cardiac insufficiency.