Hiroki Nakano , MD, PhD 1 , Kazuki Shiina , MD, PhD 1 , Takamichi Takahashi , MD 1 , Kento Kumai , MD 1 , Masatsune Fujii , MD 1 , Yoichi Iwasaki , MD, PhD 1 , Chisa Matsumoto , MD, PhD 1 , Taishiro Chikamori , MD, PhD 1 , Akira Yamashina , MD, PhD 1 , Hirofumi Tomiyama , MD, PhD , 1
18 March 2021
9 April 2021
Background: This prospective observational study examined whether hyperuricemia may be associated with impaired left ventricular (LV) systolic function and increased cardiac load resulting from increased arterial stiffness.
Methods and Results: In 1,880 middle-aged (mean [±SD] age 45±9 years) healthy men, serum uric acid (UA) levels, pre-ejection period/ejection time (PEP/ET) ratio, serum N-terminal pro B-type natriuretic peptide (NT-proBNP) levels, and brachial-ankle pulse wave velocity (baPWV) were measured at the start and end of the 3-year study period. Linear regression analysis revealed that serum UA levels measured at baseline were significantly associated with the PEP/ET ratio, but not with serum NT-proBNP levels, measured at baseline (β=0.73×10 −1, P<0.01) and at the end of the study period (β=0.68×10 −1, P<0.01). The change in the PEP/ET ratio during the study period was significantly greater in the High-UA (UA >7 mg/dL in 2009 and 2012) than Low-UA (UA ≤7 mg/dL in 2009 and 2012) group. Mediation analysis demonstrated both direct and indirect (via increases in baPWV) associations between serum UA measured at baseline and the PEP/ET ratio measured at the end of the study period.
Conclusions: In healthy middle-aged Japanese men, hyperuricemia may be associated with an accelerated decline in ventricular systolic function, both directly and indirectly, via increases in arterial stiffness.