SERUM URIC ACID AS A PREDICTOR OF LEFT VENTRICULAR EJECTION FRACTION IN PATIENTS WITH CONGESTIVE HEART FAILURE: A PROSPECTIVE OBSERVATIONAL STUDY

Background: Congestive heart failure (CHF) is a complex clinical syndrome associated with substantial morbidity and mortality. Identification of simple biochemical markers that reflect cardiac dysfunction may assist in clinical risk assessment. Serum uric acid (SUA), the end product of purine metabolism, has been associated with oxidative stress, altered renal handling and adverse cardiovascular outcomes. Its relationship with left ventricular ejection fraction (LVEF) may provide additional information regarding the severity of ventricular dysfunction. The objective is to evaluate the association between serum uric acid levels and left ventricular ejection fraction in patients with congestive heart failure. Materials and Methods: A prospective observational study was conducted among 130 patients with congestive heart failure admitted to the medical wards of ESIC Medical College and PGIMSR, Bengaluru, from January 2019 to June 2020. Patients underwent clinical assessment, serum uric acid estimation, renal function testing, electrocardiography and transthoracic two-dimensional echocardiography. The relationship between SUA and LVEF was assessed using Pearson correlation analysis. Results: Among the 130 patients, 87 (66.92%) were males and 43 (33.08%) were females. Patients aged 51–60 years constituted the largest age group (35.38%). Ischemic heart disease was the most frequent cardiovascular comorbidity (32.31%), while smoking was the most common behavioral risk factor (45.38%). Serum uric acid showed a strong negative correlation with LVEF (r = −0.725, p <0.001), indicating that increasing SUA levels were associated with decreasing LVEF. Conclusion: Higher serum uric acid levels were strongly associated with lower left ventricular ejection fraction in patients with congestive heart failure. SUA may therefore serve as a simple and readily available marker of impaired ventricular systolic function.