Increased Serum Uric Acid Levels Are Correlated with Decreased Left Atrial Appendage Peak Flow Velocity in Patients with Atrial Fibrillation

Abstract

Objective: We aimed to examine the relationship between serum uric acid levels and left atrial appendage (LAA) peak flow velocity, an indicator of the mechanical functions of the LAA, and atrial fibrillation (AF). Subjects and Methods: Transesophageal echocardiography was performed before cardioversion in 153 patients with AF. The patients were categorized into 2 groups based on their LAA blood flow velocity. Group 1 included 87 patients with a low LAA flow velocity (<35 cm/s), and group 2 comprised 66 patients with a normal LAA flow velocity (≥35 cm/s). The χ² and Student's t tests were used to compare categorical and quantitative data between the groups. Linear regression analyses were performed to demonstrate the independent association between serum uric acid levels and LAA peak flow velocity. Results: The LAA blood flow velocity was 24.62 ± 5.90 cm/s in group 1 and 49.28 ± 13.72 cm/s in group 2, respectively (p < 0.001). The serum uric acid levels were 6.88 ± 1.85 mg/dl in group 1 and 5.97 ± 1.51 mg/dl in group 2, and the difference was statistically significant (p = 0.001). There was a negative correlation between serum uric acid levels and LAA blood flow velocity (r = -0.216, p = 0.007). Multivariate regression analysis showed that serum uric acid levels, age and gender differences were significant predictors of the LAA peak flow velocity. Conclusions: High serum uric acid levels were associated with a low contractile function of the LAA and could provide additional prognostic information on future thromboembolic events in patients with AF.

Distance between the Left Atrial Appendage and Mitral Annulus Evaluated by CARTO 3 Integrated Computed Tomography Imaging

“…Because the LA is bordered anteriorly by the ascending aorta and posteriorly by the esophagus and the vertebral column, the increase in size of the LA is due to an increase in its transverse diameter. The finding that age, sex or weight were not correlated with left atrial diameters is in contrast to other studies that showed correlation between age, sex [ 14 ], weight [ 15 ], metabolic syndrome [ 16 ] or uric acid levels [ 17 ] with left atrial function and dimensions. Our study did not show this association, most probably because the patients' number was too small to reach statistical significance.…”

Comparison of Serum Uric Acid Concentrations in Subjects With and Without Atrial Fibrillation

“…Several studies suggested that oxidative stress and inflammation seemed to be involved in the pathophysiology of AF. However, whether these processes are the cause or consequence of AF remains to be determined (14,15).…”

Hyperuricaemia in Cardiovascular Diseases: A Passive or an Active Player?

“…Celik et al [ 1 ] mentioned the relationship between increased SUA levels and AF, a finding that was supported by a recent meta-analysis [ 3 ]. Furthermore, hyperuricaemia had been shown to predict stroke incidence in AF patients [ 4 ].…”

“…In this issue of Medical Principles and Practice , Celik et al [ 1 ] reported an independent negative correlation between serum uric acid (SUA) levels and blood flow velocity of the left atrial appendage (LAA) in 153 patients with atrial fibrillation (AF). Multivariate regression analysis showed that male gender (p ≤ 0.001), age (p = 0.009) and SUA levels (p = 0.010) were independent predictors of the LAA peak flow velocity [ 1 ]. The clinical implication of a low LAA flow velocity was based on its association with an increased risk of thromboembolism.…”

“…Furthermore, hyperuricaemia had been shown to predict stroke incidence in AF patients [ 4 ]. Elevated SUA levels have also been associated with increased cardiovascular (CV) morbidity and mortality, as Celik et al [ 1 ] stated. Patients with carotid atherosclerosis and peripheral artery disease may also have increased SUA concentrations compared with controls [ 5 ].…”