Impact of Gout on Left Atrial Function: A Prospective Speckle-Tracking Echocardiographic Study
The purpose of our study was to evaluate the left ventricular (LV) and left atrial (LA) function in patients with gout. A total of 173 patients underwent a comprehensive Doppler-echocardiography examination. Participants were divided into four groups-Stage 0: control (n = 35), Stage I: asymptomatic...
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| Published in | PloS one Vol. 9; no. 9; p. e108357 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Public Library of Science
24.09.2014
Public Library of Science (PLoS) |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1932-6203 1932-6203 |
| DOI | 10.1371/journal.pone.0108357 |
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| Abstract | The purpose of our study was to evaluate the left ventricular (LV) and left atrial (LA) function in patients with gout. A total of 173 patients underwent a comprehensive Doppler-echocardiography examination. Participants were divided into four groups-Stage 0: control (n = 35), Stage I: asymptomatic hyperuricemia (n = 30), Stage II: gouty arthritis without tophi (n = 58), and Stage III: tophaceous gout (n = 50). Serum uric acid levels were not significantly different between stage I, II and III. Stage III patients demonstrated a higher ratio of the transmitral and myocardial peak early diastolic velocities (E/Em) (10.50 ± 3.18 vs. 8.58 ± 2.07; P = 0.008), and larger maximal LA volume index (LAVi) (29.60 ± 9.89 vs. 20.07 ± 4.76 ml/m(2); P<0.001) compared with controls. Stage III patients had decreased LV global longitudinal systolic strain (LVε) compared with controls (-20.2 ± 3.06 vs. -21.79 ± 2.27; P = 0.002). Stage III patients also had decreased peak atrial longitudinal strain rate during ventricular systole (ALSR(syst)), peak atrial longitudinal strain rate during ventricular early diastole (ALSR(early)), and peak atrial longitudinal strain rate during ventricular late diastole (ALSR(late)) compared with controls (1.73 ± 0.48 vs. 2.05 ± 0.55 1/s, -1.44 ± 0.53 vs. -2.07 ± 0.84 1/s, -2.07 ± 0.7 vs. -2.66 ± 0.91 1/s, respectively; all P<0.005). Multiple regression analysis revealed severity of gout had an independent negative impact on LA pump function (ALSR(late)). In conclusion, gout caused LV diastolic dysfunction, LV subclinical systolic dysfunction and LA reservoir, conduit, and booster pump dysfunction. |
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| AbstractList | The purpose of our study was to evaluate the left ventricular (LV) and left atrial (LA) function in patients with gout. A total of 173 patients underwent a comprehensive Doppler-echocardiography examination. Participants were divided into four groups-Stage 0: control (n = 35), Stage I: asymptomatic hyperuricemia (n = 30), Stage II: gouty arthritis without tophi (n = 58), and Stage III: tophaceous gout (n = 50). Serum uric acid levels were not significantly different between stage I, II and III. Stage III patients demonstrated a higher ratio of the transmitral and myocardial peak early diastolic velocities (E/Em) (10.50 ± 3.18 vs. 8.58 ± 2.07; P = 0.008), and larger maximal LA volume index (LAVi) (29.60 ± 9.89 vs. 20.07 ± 4.76 ml/m(2); P<0.001) compared with controls. Stage III patients had decreased LV global longitudinal systolic strain (LVε) compared with controls (-20.2 ± 3.06 vs. -21.79 ± 2.27; P = 0.002). Stage III patients also had decreased peak atrial longitudinal strain rate during ventricular systole (ALSR(syst)), peak atrial longitudinal strain rate during ventricular early diastole (ALSR(early)), and peak atrial longitudinal strain rate during ventricular late diastole (ALSR(late)) compared with controls (1.73 ± 0.48 vs. 2.05 ± 0.55 1/s, -1.44 ± 0.53 vs. -2.07 ± 0.84 1/s, -2.07 ± 0.7 vs. -2.66 ± 0.91 1/s, respectively; all P<0.005). Multiple regression analysis revealed severity of gout had an independent negative impact on LA pump function (ALSR(late)). In conclusion, gout caused LV diastolic dysfunction, LV subclinical systolic dysfunction and LA reservoir, conduit, and booster pump dysfunction. The purpose of our study was to evaluate the left ventricular (LV) and left atrial (LA) function in patients with gout. A total of 173 patients underwent a comprehensive Doppler-echocardiography examination. Participants were divided into four groups-Stage 0: control (n = 35), Stage I: asymptomatic hyperuricemia (n = 30), Stage II: gouty arthritis without tophi (n = 58), and Stage III: tophaceous gout (n = 50). Serum uric acid levels were not significantly different between stage I, II and III. Stage III patients demonstrated a higher ratio of the transmitral and myocardial peak early diastolic velocities (E/Em) (10.50 ± 3.18 vs. 8.58 ± 2.07; P = 0.008), and larger maximal LA volume index (LAVi) (29.60 ± 9.89 vs. 20.07 ± 4.76 ml/m(2); P<0.001) compared with controls. Stage III patients had decreased LV global longitudinal systolic strain (LVε) compared with controls (-20.2 ± 3.06 vs. -21.79 ± 2.27; P = 0.002). Stage III patients also had decreased peak atrial longitudinal strain rate during ventricular systole (ALSR(syst)), peak atrial longitudinal strain rate during ventricular early diastole (ALSR(early)), and peak atrial longitudinal strain rate during ventricular late diastole (ALSR(late)) compared with controls (1.73 ± 0.48 vs. 2.05 ± 0.55 1/s, -1.44 ± 0.53 vs. -2.07 ± 0.84 1/s, -2.07 ± 0.7 vs. -2.66 ± 0.91 1/s, respectively; all P<0.005). Multiple regression analysis revealed severity of gout had an independent negative impact on LA pump function (ALSR(late)). In conclusion, gout caused LV diastolic dysfunction, LV subclinical systolic dysfunction and LA reservoir, conduit, and booster pump dysfunction.The purpose of our study was to evaluate the left ventricular (LV) and left atrial (LA) function in patients with gout. A total of 173 patients underwent a comprehensive Doppler-echocardiography examination. Participants were divided into four groups-Stage 0: control (n = 35), Stage I: asymptomatic hyperuricemia (n = 30), Stage II: gouty arthritis without tophi (n = 58), and Stage III: tophaceous gout (n = 50). Serum uric acid levels were not significantly different between stage I, II and III. Stage III patients demonstrated a higher ratio of the transmitral and myocardial peak early diastolic velocities (E/Em) (10.50 ± 3.18 vs. 8.58 ± 2.07; P = 0.008), and larger maximal LA volume index (LAVi) (29.60 ± 9.89 vs. 20.07 ± 4.76 ml/m(2); P<0.001) compared with controls. Stage III patients had decreased LV global longitudinal systolic strain (LVε) compared with controls (-20.2 ± 3.06 vs. -21.79 ± 2.27; P = 0.002). Stage III patients also had decreased peak atrial longitudinal strain rate during ventricular systole (ALSR(syst)), peak atrial longitudinal strain rate during ventricular early diastole (ALSR(early)), and peak atrial longitudinal strain rate during ventricular late diastole (ALSR(late)) compared with controls (1.73 ± 0.48 vs. 2.05 ± 0.55 1/s, -1.44 ± 0.53 vs. -2.07 ± 0.84 1/s, -2.07 ± 0.7 vs. -2.66 ± 0.91 1/s, respectively; all P<0.005). Multiple regression analysis revealed severity of gout had an independent negative impact on LA pump function (ALSR(late)). In conclusion, gout caused LV diastolic dysfunction, LV subclinical systolic dysfunction and LA reservoir, conduit, and booster pump dysfunction. The purpose of our study was to evaluate the left ventricular (LV) and left atrial (LA) function in patients with gout. A total of 173 patients underwent a comprehensive Doppler-echocardiography examination. Participants were divided into four groups–Stage 0: control (n = 35), Stage I: asymptomatic hyperuricemia (n = 30), Stage II: gouty arthritis without tophi (n = 58), and Stage III: tophaceous gout (n = 50). Serum uric acid levels were not significantly different between stage I, II and III. Stage III patients demonstrated a higher ratio of the transmitral and myocardial peak early diastolic velocities (E/Em) (10.50±3.18 vs. 8.58±2.07; P = 0.008), and larger maximal LA volume index (LAVi) (29.60±9.89 vs. 20.07±4.76 ml/m2; P<0.001) compared with controls. Stage III patients had decreased LV global longitudinal systolic strain (LVε) compared with controls (−20.2±3.06 vs. −21.79±2.27; P = 0.002). Stage III patients also had decreased peak atrial longitudinal strain rate during ventricular systole (ALSRsyst), peak atrial longitudinal strain rate during ventricular early diastole (ALSRearly), and peak atrial longitudinal strain rate during ventricular late diastole (ALSRlate) compared with controls (1.73±0.48 vs. 2.05±0.55 1/s, −1.44±0.53 vs. −2.07±0.84 1/s, −2.07±0.7 vs. −2.66±0.91 1/s, respectively; all P<0.005). Multiple regression analysis revealed severity of gout had an independent negative impact on LA pump function (ALSRlate). In conclusion, gout caused LV diastolic dysfunction, LV subclinical systolic dysfunction and LA reservoir, conduit, and booster pump dysfunction. The purpose of our study was to evaluate the left ventricular (LV) and left atrial (LA) function in patients with gout. A total of 173 patients underwent a comprehensive Doppler-echocardiography examination. Participants were divided into four groups–Stage 0: control (n = 35), Stage I: asymptomatic hyperuricemia (n = 30), Stage II: gouty arthritis without tophi (n = 58), and Stage III: tophaceous gout (n = 50). Serum uric acid levels were not significantly different between stage I, II and III. Stage III patients demonstrated a higher ratio of the transmitral and myocardial peak early diastolic velocities (E/Em) (10.50±3.18 vs. 8.58±2.07; P = 0.008), and larger maximal LA volume index (LAVi) (29.60±9.89 vs. 20.07±4.76 ml/m 2 ; P<0.001) compared with controls. Stage III patients had decreased LV global longitudinal systolic strain (LVε) compared with controls (−20.2±3.06 vs. −21.79±2.27; P = 0.002). Stage III patients also had decreased peak atrial longitudinal strain rate during ventricular systole (ALSR syst ), peak atrial longitudinal strain rate during ventricular early diastole (ALSR early ), and peak atrial longitudinal strain rate during ventricular late diastole (ALSR late ) compared with controls (1.73±0.48 vs. 2.05±0.55 1/s, −1.44±0.53 vs. −2.07±0.84 1/s, −2.07±0.7 vs. −2.66±0.91 1/s, respectively; all P<0.005). Multiple regression analysis revealed severity of gout had an independent negative impact on LA pump function (ALSR late ). In conclusion, gout caused LV diastolic dysfunction, LV subclinical systolic dysfunction and LA reservoir, conduit, and booster pump dysfunction. |
| Author | Hsu, Jen-Te Lin, Jing-Chi Chang, Shih-Tai Chen, Mien-Cheng Pan, Kuo-Li Chung, Chang-Min Lin, Chun-Liang |
| AuthorAffiliation | 3 Division of Nephrology, Chang Gung Memorial Hospital, Chiayi, Taiwan 1 Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan 2 Division of Allergy and Immunology and Rheumatology, Chang Gung Memorial Hospital, Chiayi, Taiwan 5 Division of Cardiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan University of Bologna, Italy 4 The Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan |
| AuthorAffiliation_xml | – name: 4 The Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan – name: 2 Division of Allergy and Immunology and Rheumatology, Chang Gung Memorial Hospital, Chiayi, Taiwan – name: 1 Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan – name: 3 Division of Nephrology, Chang Gung Memorial Hospital, Chiayi, Taiwan – name: University of Bologna, Italy – name: 5 Division of Cardiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan |
| Author_xml | – sequence: 1 givenname: Kuo-Li surname: Pan fullname: Pan, Kuo-Li – sequence: 2 givenname: Jing-Chi surname: Lin fullname: Lin, Jing-Chi – sequence: 3 givenname: Chun-Liang surname: Lin fullname: Lin, Chun-Liang – sequence: 4 givenname: Mien-Cheng surname: Chen fullname: Chen, Mien-Cheng – sequence: 5 givenname: Shih-Tai surname: Chang fullname: Chang, Shih-Tai – sequence: 6 givenname: Chang-Min surname: Chung fullname: Chung, Chang-Min – sequence: 7 givenname: Jen-Te surname: Hsu fullname: Hsu, Jen-Te |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/25250773$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1038_s41440_021_00752_9 crossref_primary_10_3233_ICA_160517 crossref_primary_10_3389_fphys_2023_1280178 crossref_primary_10_1016_j_numecd_2021_01_023 crossref_primary_10_1111_echo_15911 crossref_primary_10_2147_IJGM_S450951 crossref_primary_10_2217_ijr_15_34 crossref_primary_10_1016_j_pcad_2020_03_005 |
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| Copyright | 2014 Pan et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2014 Pan et al 2014 Pan et al |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Conceived and designed the experiments: KLP JCL CLL. Performed the experiments: KLP JCL STC CMC JTH. Analyzed the data: KLP JCL MCC. Wrote the paper: KLP JCL CLL MCC. Competing Interests: The authors have declared that no competing interests exist. |
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| References_xml | – volume: 33 start-page: 595 year: 2012 ident: ref19 article-title: Regression of cardiac hypertrophy by granulocyte colony-stimulating factor-stimulated interleukin-1β synthesis publication-title: Eur Heart J doi: 10.1093/eurheartj/ehr434 – volume: 13 start-page: 243 year: 2012 ident: ref26 article-title: Left atrial function assessed by speckle tracking echocardiography as a predictor of new-onset non-valvular atrial fibrillation: results from a prospective study in 580 adults publication-title: Eur Heart J Cardiovasc Imaging doi: 10.1093/ejechocard/jer251 – volume: 94 start-page: 511 year: 2004 ident: ref9 article-title: Echocardiographic evidence of left atrial abnormality in young patients with lone paroxysmal atrial fibrillation publication-title: Am J Cardiol doi: 10.1016/j.amjcard.2004.05.009 – volume: 49 start-page: 1229 year: 2010 ident: ref17 article-title: Inflammation, oxidative stress and lipids: The risk triad for atherosclerosis in gout publication-title: Rheumatology (Oxford) doi: 10.1093/rheumatology/keq037 – volume: 143 start-page: 1107 year: 2002 ident: ref7 article-title: Elevated serum uric acid levels are associated with diastolic dysfunction in patients with dilated cardiomyopathy publication-title: Am Heart J doi: 10.1067/mhj.2002.122122 – volume: 22 start-page: 1972 year: 1993 ident: ref25 article-title: Estimation of left ventricular filling pressures using two-dimensional and Doppler echocardiography in adult patients with cardiac disease. Additional value of analyzing left atrial size, left atrial ejection fraction and the difference in duration of pulmonary venous and mitral flow velocity at atrial contraction publication-title: J Am Coll Cardiol doi: 10.1016/0735-1097(93)90787-2 – volume: 18 start-page: 138 year: 2012 ident: ref15 article-title: Hyperuricemia and the echocardiographic measures of myocardial dysfunction publication-title: Congest Heart Fail doi: 10.1111/j.1751-7133.2011.00259.x – volume: 41 start-page: 237 year: 1988 ident: ref20 article-title: Gout and coronary heart disease: the Framingham Study publication-title: J Clin Epidemiol doi: 10.1016/0895-4356(88)90127-8 – volume: 49 start-page: 141 year: 2010 ident: ref21 article-title: Gout: an independent risk factor for all-cause and cardiovascular mortality publication-title: Rheumatology (Oxford) doi: 10.1093/rheumatology/kep364 – volume: 102 start-page: 1788 year: 2000 ident: ref22 article-title: Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures: A comparative simultaneous Doppler-catheterization study publication-title: Circulation doi: 10.1161/01.CIR.102.15.1788 – volume: 51 start-page: 209 year: 2010 ident: ref3 article-title: Uric acid elevation in atrial fibrillation publication-title: Hellenic J Cardiol – volume: 164 start-page: 1546 year: 2004 ident: ref4 article-title: Uric acid level as a risk factor for cardiovascular and all-cause mortality in middle-aged men: a prospective cohort study publication-title: Arch Intern Med doi: 10.1001/archinte.164.14.1546 – volume: 364 start-page: 443 year: 2011 ident: ref1 article-title: Clinical practice. 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| SubjectTerms | Adult Aged Arthritis Atrial Function, Left Blood pressure Cardiac arrhythmia Cardiology Cardiomyopathy Cardiovascular disease Cholesterol Diastole Doppler effect Echocardiography Echocardiography, Doppler - methods Female Flow velocity Gout Gout - blood Gout - complications Gout - pathology Health risk assessment Heart Heart failure Humans Hypertension Hyperuricemia Inflammation Male Medicine and Health Sciences Middle Aged Mortality Multiple regression analysis Patients Prospective Studies Regression Analysis Rheumatism Rheumatology Strain rate Systole Uric acid Uric Acid - blood Ventricle Ventricular Dysfunction, Left - etiology Ventricular Dysfunction, Left - physiopathology |
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| Title | Impact of Gout on Left Atrial Function: A Prospective Speckle-Tracking Echocardiographic Study |
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