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Gancheva R, Kundurdjiev A, Ivanova M, Kundurzhiev T, Kolarov Z. Evaluation of cardiovascular risk in stages of gout by a complex multimodal ultrasonography. Rheumatol Int 2016; 37:121-130. [PMID: 27577941 DOI: 10.1007/s00296-016-3556-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 08/22/2016] [Indexed: 12/22/2022]
Abstract
The aim of our work was to assess ultrasound features of cardiovascular (CV) risk in stages of gout. Cross-sectional complex multimodal ultrasound study of 169 age-matched patients, with similar distribution of arterial hypertension, diabetes mellitus, obesity and chronic renal failure, was divided into four groups: 41 with asymptomatic hyperuricemia, 52 gout without tophi, 42 gouty tophi and 34 controls with osteoarthritis. Parameters independently associated with CV risk were measured: renal resistive index (RRI), left ventricular mass index (LVMi), mitral annulus early diastolic velocity (e'), intima-media thickness (IMT) and common carotid artery resistive index (CCARI). Multivariate analyses were performed to evaluate the impact of gout stages and CV risk factors on ultrasound alterations. Gouty tophi increased the risk of having IMT >0.90 mm with an OR 11.51 (95 % CI 2.32-57.21, p = 0.003), gout without tophi raised the risk with an OR 6.25 (95 % CI 1.37-28.44, p = 0.018), while asymptomatic hyperuricemia had no effect on IMT. The category of CCARI >0.70 was influenced by tophi with an OR 11.18 (95 % CI 2.61-47.83, p = 0.001) and by arterial hypertension with an OR 3.22 (95 % CI 1.11-9.36, p = 0.032). Neither asymptomatic hyperuricemia nor gout without tophi modified the development of abnormally high CCARI. Gout stages had no impact on LVMi, e' and RRI. Tophi are related to worsened ultrasonographic parameters evaluating target organs in gout, relative to earlier stages of the disease. They create a strong risk of carotid arteries' changes even beyond arterial hypertension.
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Affiliation(s)
- Rada Gancheva
- Department of Internal Medicine, Medical Faculty, Clinic of Rheumatology, Medical University, University Hospital St. Iv. Rilski, 13, Urvich St., 1612, Sofia, Bulgaria.
| | - Atanas Kundurdjiev
- Department of Internal Medicine, Medical Faculty, Clinic of Nephrology, Medical University, University Hospital St. Iv. Rilski, 15, Iv. Geshov St., 1431, Sofia, Bulgaria
| | - Mariana Ivanova
- Department of Internal Medicine, Medical Faculty, Clinic of Rheumatology, Medical University, University Hospital St. Iv. Rilski, 13, Urvich St., 1612, Sofia, Bulgaria
| | - Todor Kundurzhiev
- Faculty of Public Health, Medical University, 8, Bialo more St., 1527, Sofia, Bulgaria
| | - Zlatimir Kolarov
- Department of Internal Medicine, Medical Faculty, Clinic of Rheumatology, Medical University, University Hospital St. Iv. Rilski, 13, Urvich St., 1612, Sofia, Bulgaria
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