Association of Hyperuricemia With Heart Failure Phenotype and Clinical Severity in Patients With Congestive Heart Failure

Background: Serum uric acid (SUA) has increasingly been investigated as a readily available biochemical markerassociated with cardiovascular dysfunction. In heart failure, elevated SUA may reflect altered purine metabolism, increasedxanthine oxidase activity, impaired renal perfusion, and neurohormonal or oxidative stress-related changes. The objective isto evaluate the association between serum uric acid levels and clinical severity of congestive heart failure (CHF), withparticular emphasis on left ventricular systolic function assessed by left ventricular ejection fraction (LVEF). Materials andMethods: A prospective observational study was conducted among 130 patients aged 18–65 years presenting with clinicalfeatures of acute congestive heart failure and admitted to the medical wards of ESIC Medical College and PGIMSR,Bengaluru, between January 2019 and June 2020. Clinical examination, biochemical investigations, serum uric acidestimation, electrocardiography, renal function assessment, and transthoracic two-dimensional echocardiography wereperformed. The relationship between SUA and LVEF was assessed using Pearson correlation analysis. Results: Dyspneawas reported in 58.47% of participants, while bilateral lower-limb swelling was present in 50.00%. Pedal edema was themost frequent physical finding (95.38%), followed by raised jugular venous pressure (59.23%). Mean SUA was 6.35 ± 1.78mg/dL, whereas mean LVEF was 39.78 ± 8.73%. A strong inverse correlation was observed between SUA and LVEF (r =−0.725, p <0.001), indicating that higher SUA levels were associated with poorer ventricular systolic function. Conclusion:Higher serum uric acid levels were significantly associated with lower LVEF in patients with CHF. SUA may thereforeprovide a simple biochemical indication of adverse cardiac functional status and could complement clinical andechocardiographic assessment of disease severity.