Study Of The Correlation Between Serum Uric Acid,Left Atrial Diameter And Atrial Fibrillation In Patients With Ischemic Cardiomyopathy

Objective: This work aims to investigate the correlation between serum uric acid,left atrial diameter and atrial fibrillation in patients with ischemic cardiomyopathy.Methods: According to the results of coronary angiography and electrocardiogram,232 patients with ischemic cardiomyopathy were selected.All the patients were diagnosed with ischemic cardiomyopathy(ICM)in our hospital for the first time from September 2013 to January 2019.The 232 patients were divided into ICM atrial fibrillation group(n = 80)and ICM sinus rhythm group(n =152).The general clinical data,laboratory data and color Doppler echocardiography data were compared between the two groups.According to the criteria of hyperuricemia,the patients were divided into ICM with HUA group(n = 111)and ICM without HUA group(n = 121).The incidence of atrial fibrillation and echocardiographic data were compared between the two groups.According to the serum uric acid concentration,the patients were divided into four groups according to the distance(120 mmol/l).The incidence of atrial fibrillation and color Doppler echocardiography were compared between groups I(SUA ?332 mol/L,n = 53),groups II(SUA333~452 mol/L,n = 67),groups III(SUA 453~572 mol/L,n =61)and groups IV(SUA ?73 mol/L,n = 51),To further analyze the structural correlation between uric acid and color Doppler echocardiography.Result:(1)Age,serum uric acid(SUA),left atrial diameter(LAD),total bilirubin(TBIL),gamma-glutamyltransferase(GGT)in ICM with atrial fibrillationgroup and ICM sinus rhythm group were significantly higher than those in ICM sinus rhythm group(P < 0.05),while left ventricular ejection fraction(LVEF)was significantly lower than that in ICM sinus rhythm group(P < 0.01).After adjustment for age,SUA,LAD,LVEF,TBIL and GGT,logistic regression analysis showed that only age(OR=1.056;95%CI:0.974~1.006;P=0.007)and LAD(OR=1.070;95%CI:1.019~1.095;P=0.002)were independent risk factors for atrial fibrillation in ICM patients,but uric acid was not significantly different from atrial fibrillation in ICM patients.The incidence of atrial fibrillation in ICM with HUA group was 42(42.44%),and that in ICM with non-HUA group was 39(32.2%).There was no significant difference between the two groups(P = 0.451).According to the concentration of SUA,there were 16 patients(30.2%),20 patients(29.9%),21patients(34.4%)and 24 patients(47.1%)with atrial fibrillation in each group.There was no significant difference in the incidence of atrial fibrillation among the four groups(P = 0.204).(2)?To compare the cardiac color Doppler ultrasound indices of ICM with HUA group(n = 111)and ICM without HUA group(n = 121).The results showed that HUA was positively correlated with LAD and LVDD(P < 0.001),while HUA was negatively correlated with LVEF(P < 0.001).Correlation analysis displays showed that SUA was positively correlated with LAD(r = 0.365,P < 0.001),positively correlated with LVDD(r = 0.254,P < 0.001)and negatively correlated with LVEF(r =-0.287,P < 0.001).Conclusion: 1.LAD may be an independent risk factor for ICM atrial fibrillation.2.There is no independent correlation between SUA and ICM atrial fibrillation,but SUA may be positively correlated with LAD.