Assessment of the Association Between serum Uric Acid level and the Predicted Risk Score of Sudden Cardiac Death at Five Years in Patients with Hypertrophic Cardiomyopathy [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. Ahead of Print: TKDA-60094 | DOI: 10.5543/tkda.2017.60094

Assessment of the Association Between serum Uric Acid level and the Predicted Risk Score of Sudden Cardiac Death at Five Years in Patients with Hypertrophic Cardiomyopathy

Sinem Özyılmaz1, Muhammet Hulusi Satılmışoğlu1, Mehmet Gül1, Huseyin Uyarel2, Osman Akin Serdar3
11Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
2Bezmialem Vakıf University, Faculty of Medicine, Department of Cardiology, Istanbul, Turkey
3Uludag University, Faculty of Medicine, Bursa, Turkey, Department of Cardiology


OBJECTIVE
The aim of this study was to determine the relationship between serum uric acid(UA) level and the predicted risk score of sudden cardiac death in five years(the HCM risk-SCD), galectin-3 level, and positive fragmented QRS(fQRS) on electrocardiography(ECG) in patients with hypertrophic cardiomyopathy(HCM).

METHODS
This was a prospective observational study. One hundred and fifteen consecutive patients(age>17years) with HCM and 80 healthy subjects were included in the study. The HCM risk-SCD score(%), galectin-3 level, and fQRS were evaluated on ECG in all patients.

RESULTS
Serum UA, galectin-3 level, UA/Creatinine(Cr), incidence of ventricular tachycardia(VT) and syncope, some echocardiographic parameters were significantly higher in the patient group than in the control group(all p<0.05). Uric acid value was significantly higher in patients with high score of the HCM Risk-SCD, positive fQRS, high galectin-3 level, VT incidence, requirement of implantable cardioverter defibrillator(ICD) implantation, CPR(cardiopulmonary resuscitation) than in those without(HCM Risk-SCD>6%, UA: 6.71±1.29mg/dl, HCM Risk-SCD≤5.9%, UA: 5.84±1.39mg/dl, p=0.001; fQRS(+), UA: 6.56±1.20mg/dl, fQRS(-), UA: 5.63±1.49mg/dl, p<0.001; galectin-3>6.320pg/ml, UA: 6.56±1.27mg/dl, galectin-3≤6.310pg/ml, p=0.016; left atrium anterior-posterior dimension(LAAPD)>36mm, UA: 6.31±1.33mg/dl, LAAPD<36mm, UA: 5.20±1.60mg/dl, p=0.005; ventricular tachycardia(VT)(+), UA: 6.83±1.19mg/dl, VT(-), UA: 5.97±1.42mg/dl, p=0.008; ICD(+), UA: 7.08±0.88mg/dl, ICD(-), UA: 6.06±1.42mg/dl, p=0.022; CPR(+), UA: 7.03±0.96mg/dl, CPR(-), UA: 6.04±1.42mg/dl, p=0.018). A statistically significant correlation was observed between UA and HCM Risk-SCD, galectin-3 level, LAAPD, LVM(respectively r and p values: 0.355; <0.001, 0.297; 0.002, 0.309; 0.001, 0.276; 0.003).

CONCLUSION
Serum UA level was significantly higher in patients with HCM compared to the control group. High UA level was associated with higher the HCM risk-SCD score, positive fQRS, galectin-3 levels, LAAPD, VT incidence, requirement for ICD implantation and CPR in patients with HCM.

Keywords: Uric acid, cardiomyopathy, hypertrophic, sudden cardiac death, risk

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Corresponding Author: Sinem Özyılmaz, Türkiye
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