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Sn VP, Jaramillo AP, Yasir M, Hussein S, Singareddy S, Iyer N, Nath TS. Hyperuricemia and Its Association With the Severity and Complications of Congestive Heart Failure: A Systematic Review. Cureus 2023; 15:e45246. [PMID: 37842413 PMCID: PMC10576591 DOI: 10.7759/cureus.45246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 09/13/2023] [Indexed: 10/17/2023] Open
Abstract
Several studies have shown that an association exists between hyperuricemia and heart failure. Despite several innovative management strategies, heart failure is a significant cause of mortality worldwide. Hyperuricemia in heart failure patients leads to poorer outcomes. Additionally, hyperuricemia can be a strong surrogate marker for increased oxidative stress in heart failure patients. This oxidative stress leads to vascular endothelial damage and is linked to worsening heart failure and subsequent mortality. Hence, the measurement of serum uric acid levels in these patients can predict the present and future risk of complications of heart failure. Despite this knowledge, serum uric acid levels are not usually followed up in heart failure patients. This systematic review aims to give additional clarity to this association. We used research from the last twenty years (2002 to 2022) obtained from databases such as PubMed, PubMed Central (PMC), Google Scholar, and Science Direct. We used the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) 2020 guidelines. We removed duplicates, screened articles on the basis of title and abstract, applied eligibility criteria, and performed quality appraisal. Eventually, 15 articles were selected for review. There were 12 observational studies, two randomized controlled trials, and one meta-analysis. Our review showed that serum uric acid elevation is associated with the severity and complications of congestive heart failure. Serum uric acid can serve as a useful surrogate marker of oxidative stress in congestive heart failure (CHF) patients. The role of xanthine oxidase inhibitors needs to be evaluated further in CHF patients.
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Affiliation(s)
- Vijay P Sn
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Arturo P Jaramillo
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Mohamed Yasir
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Sally Hussein
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Sanjana Singareddy
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Nandhini Iyer
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Tuheen Sankar Nath
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Passos RS, Ribeiro ÍJS, Freire IV, Teles MF, Pires RA, Schettino L, Oliveira AA, Casotti CA, Pereira R. Hyperuricemia is associated with sympathovagal imbalance in older adults. Arch Gerontol Geriatr 2020; 90:104132. [PMID: 32570110 DOI: 10.1016/j.archger.2020.104132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE This study aimed to compare heart rate variability (HRV) parameters obtained through symbolic analysis (SA), between older adults with and without hyperuricemia. METHODS This is a cross-sectional study including 202 community-dwelling old adults, which was clinically stratified as with or without hyperuricemia, according to the cutoff point of serum uric acid ≥ 6 mg/dL for women and ≥ 7 mg/dL for men. Successive RR intervals were recorded along 5 min and analyzed with SA method. 0 V%, 1 V% and 2 V% patterns were quantified and compared between groups. Comparisons were carried out through parametric or nonparametric tests, according to the data distribution characteristics, evaluated by Kolmogorov-Smirnov test. The significance level was set as p ≤ 0.05 for all statistical procedures. RESULTS The prevalence of hyperuricemia was 67.8 %, and the hyperuricemic older adults exhibited significant higher values for V0% and lower values for V2% parameters when compared to normouricemic older adults. CONCLUSION These results suggesting a sympathovagal imbalance in hyperuricemic older adults, characterized by greater sympathetic predominance (0 V%) and lower vagal modulation (2 V%) at rest conditions.
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Affiliation(s)
- R S Passos
- Integrative Physiology Research Center, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia (UESB), Jequie, 45210-506, Bahia, Brazil; Research Group in Neuromuscular Physiology, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia (UESB), Jequie, 45210-506, Bahia, Brazil; Postgraduate Program in Nursing & Health, State University of Southwest Bahia (UESB), Jequie, 45210-506, Bahia, Brazil
| | - Ícaro J S Ribeiro
- Integrative Physiology Research Center, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia (UESB), Jequie, 45210-506, Bahia, Brazil; Research Group in Neuromuscular Physiology, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia (UESB), Jequie, 45210-506, Bahia, Brazil; Postgraduate Program in Nursing & Health, State University of Southwest Bahia (UESB), Jequie, 45210-506, Bahia, Brazil
| | - Ivna Vidal Freire
- Integrative Physiology Research Center, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia (UESB), Jequie, 45210-506, Bahia, Brazil; Research Group in Neuromuscular Physiology, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia (UESB), Jequie, 45210-506, Bahia, Brazil; Postgraduate Program in Nursing & Health, State University of Southwest Bahia (UESB), Jequie, 45210-506, Bahia, Brazil
| | - Mauro Fernandes Teles
- Integrative Physiology Research Center, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia (UESB), Jequie, 45210-506, Bahia, Brazil; Research Group in Neuromuscular Physiology, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia (UESB), Jequie, 45210-506, Bahia, Brazil; Postgraduate Program in Nursing & Health, State University of Southwest Bahia (UESB), Jequie, 45210-506, Bahia, Brazil
| | - Ramon Alves Pires
- Integrative Physiology Research Center, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia (UESB), Jequie, 45210-506, Bahia, Brazil; Research Group in Neuromuscular Physiology, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia (UESB), Jequie, 45210-506, Bahia, Brazil; Postgraduate Program in Nursing & Health, State University of Southwest Bahia (UESB), Jequie, 45210-506, Bahia, Brazil
| | - Ludmila Schettino
- Integrative Physiology Research Center, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia (UESB), Jequie, 45210-506, Bahia, Brazil; Research Group in Neuromuscular Physiology, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia (UESB), Jequie, 45210-506, Bahia, Brazil; Postgraduate Program in Nursing & Health, State University of Southwest Bahia (UESB), Jequie, 45210-506, Bahia, Brazil
| | - Alinne Alves Oliveira
- Integrative Physiology Research Center, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia (UESB), Jequie, 45210-506, Bahia, Brazil; Research Group in Neuromuscular Physiology, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia (UESB), Jequie, 45210-506, Bahia, Brazil; Postgraduate Program in Nursing & Health, State University of Southwest Bahia (UESB), Jequie, 45210-506, Bahia, Brazil
| | - Cezar Augusto Casotti
- Health Department, State University of Southwest Bahia (UESB), Jequie, Bahia, 45210-506, Brazil
| | - Rafael Pereira
- Integrative Physiology Research Center, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia (UESB), Jequie, 45210-506, Bahia, Brazil; Research Group in Neuromuscular Physiology, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia (UESB), Jequie, 45210-506, Bahia, Brazil; Postgraduate Program in Nursing & Health, State University of Southwest Bahia (UESB), Jequie, 45210-506, Bahia, Brazil.
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Sympathetic overactivation predicts body weight loss in patients with heart failure. Auton Neurosci 2019; 223:102625. [PMID: 31896025 DOI: 10.1016/j.autneu.2019.102625] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 12/19/2019] [Accepted: 12/20/2019] [Indexed: 11/20/2022]
Abstract
Neurohumoral activation is frequently observed in chronic heart failure (HF) patients who develop body weight (BW) loss. We therefore hypothesized that sympathetic overactivation can predict progression of BW loss in HF patients with reduced ejection fraction. We prospectively evaluated BW loss in 108 non-edematous HF in whom muscle sympathetic nerve activity (MSNA) was measured. Follow-up began on the day of first MSNA measurement. Patients with BW loss of ≥5% of baseline BW during the first year of follow-up were considered to be experiencing BW loss. Maximal BW loss (%) and time to first BW loss (i.e., ≥5%) were assessed. Primary cardiovascular endpoints included cardiovascular death and HF hospitalization. Predictors of outcomes were assessed on univariate, multivariate, and Kaplan-Meier analyses. BW loss ≥5% occurred in 14% of enrolled patients. Mean MSNA was significantly higher in the BW loss group than in the no-BW loss group (80 versus 58 bursts/100 beats; p < 0.001). Moreover, multivariate Cox proportional hazard regression analysis revealed MSNA as the only independent predictor of BW loss. Multiple linear regression analysis identified MSNA as the strongest independent marker of maximal BW loss, even after adjusting for univariate predictors. BW loss, MSNA and several variables also correlated significantly with poor outcomes in univariate analyses. However, multivariate analysis only showed MSNA and NYHA III/IV as independent prognostic predictors, while BW loss did not predict prognosis. MSNA offered the most sensitive marker of BW loss in HF patients, but MSNA, not BW loss, was an independent predictor of poor outcome.
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