Uric Acid Predicts Recovery of Left Ventricular Function and Adverse Events in Heart Failure With Reduced Ejection Fraction: Potential Mechanistic Insight From Network Analyses
Background and AimsHeart failure with reduced ejection fraction (HFrEF) still carries a high risk for a sustained decrease in left ventricular ejection fraction (LVEF) even with the optimal medical therapy. Currently, there is no effective tool to stratify these patients according to their recovery...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-07-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.853870/full |
| _version_ | 1811289409461420032 |
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| author | Xiqiang Wang Xiude Fan Xiude Fan Xiude Fan Qihui Wu Qihui Wu Jing Liu Linyan Wei Dandan Yang Xiang Bu Xiaoxiang Liu Aiqun Ma Tomohiro Hayashi Gongchang Guan Yu Xiang Shuang Shi Junkui Wang Jiansong Fang |
| author_facet | Xiqiang Wang Xiude Fan Xiude Fan Xiude Fan Qihui Wu Qihui Wu Jing Liu Linyan Wei Dandan Yang Xiang Bu Xiaoxiang Liu Aiqun Ma Tomohiro Hayashi Gongchang Guan Yu Xiang Shuang Shi Junkui Wang Jiansong Fang |
| author_sort | Xiqiang Wang |
| collection | DOAJ |
| description | Background and AimsHeart failure with reduced ejection fraction (HFrEF) still carries a high risk for a sustained decrease in left ventricular ejection fraction (LVEF) even with the optimal medical therapy. Currently, there is no effective tool to stratify these patients according to their recovery potential. We tested the hypothesis that uric acid (UA) could predict recovery of LVEF and prognosis of HFrEF patients and attempted to explore mechanistic relationship between hyperuricemia and HFrEF.MethodsHFrEF patients with hyperuricemia were selected from the National Inpatient Sample (NIS) 2016–2018 database and our Xianyang prospective cohort study. Demographics, cardiac risk factors, and cardiovascular events were identified. Network-based analysis was utilized to examine the relationship between recovery of LVEF and hyperuricemia, and we further elucidated the underlying mechanisms for the impact of hyperuricemia on HFrEF.ResultsAfter adjusting confounding factors by propensity score matching, hyperuricemia was a determinant of HFrEF [OR 1.247 (1.172–1.328); P < 0.001] of NIS dataset. In Xianyang prospective cohort study, hyperuricemia is a significant and independent risk factor for all-cause death (adjusted HR 2.387, 95% CI 1.141–4.993; P = 0.021), heart failure readmission (adjusted HR 1.848, 95% CI 1.048–3.259; P = 0.034), and composite events (adjusted HR 1.706, 95% CI 1.001–2.906; P = 0.049) in HFrEF patients. UA value at baseline was negatively correlated to LVEF of follow-ups (r = −0.19; P = 0.046). Cutoff UA value of 312.5 μmmol/L at baseline can work as a predictor of LVEF recovery during follow-up, with the sensitivity of 66.7%, the specificity of 35.1%, and the accuracy of 0.668 (95% CI, 0.561–0.775; P = 0.006). Moreover, gene overlap analysis and network proximity analysis demonstrated a strong correlation between HFrEF and Hyperuricemia.ConclusionLower baseline UA value predicted the LVEF recovery and less long-term adverse events in HFrEF patients. Our results provide new insights into underlying mechanistic relationship between hyperuricemia and HFrEF. |
| first_indexed | 2024-04-13T03:54:02Z |
| format | Article |
| id | doaj.art-421d8ad634fe4b9c9f6a4fadca3555ed |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-13T03:54:02Z |
| publishDate | 2022-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-421d8ad634fe4b9c9f6a4fadca3555ed2022-12-22T03:03:42ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-07-01910.3389/fcvm.2022.853870853870Uric Acid Predicts Recovery of Left Ventricular Function and Adverse Events in Heart Failure With Reduced Ejection Fraction: Potential Mechanistic Insight From Network AnalysesXiqiang Wang0Xiude Fan1Xiude Fan2Xiude Fan3Qihui Wu4Qihui Wu5Jing Liu6Linyan Wei7Dandan Yang8Xiang Bu9Xiaoxiang Liu10Aiqun Ma11Tomohiro Hayashi12Gongchang Guan13Yu Xiang14Shuang Shi15Junkui Wang16Jiansong Fang17Department of Cardiovascular Medicine, Shaanxi Provincial People's Hospital, Xi'an, ChinaDepartment of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, ChinaShandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, ChinaShandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, ChinaScience and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, ChinaClinical Research Center, Hainan Provincial Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Haikou, ChinaDepartment of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, ChinaDepartment of General Practice, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Cardiovascular Medicine, The Second Affiliated Hospital of Zhejiang University, Hangzhou, ChinaDepartment of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, ChinaDepartment of Cardiovascular Medicine, Shaanxi Provincial People's Hospital, Xi'an, ChinaDepartment of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China0Center for Cardiovascular Research, Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis, MO, United StatesDepartment of Cardiovascular Medicine, Shaanxi Provincial People's Hospital, Xi'an, ChinaDepartment of Cardiovascular Medicine, Shaanxi Provincial People's Hospital, Xi'an, ChinaDepartment of Cardiovascular Medicine, Shaanxi Provincial People's Hospital, Xi'an, ChinaDepartment of Cardiovascular Medicine, Shaanxi Provincial People's Hospital, Xi'an, ChinaScience and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, ChinaBackground and AimsHeart failure with reduced ejection fraction (HFrEF) still carries a high risk for a sustained decrease in left ventricular ejection fraction (LVEF) even with the optimal medical therapy. Currently, there is no effective tool to stratify these patients according to their recovery potential. We tested the hypothesis that uric acid (UA) could predict recovery of LVEF and prognosis of HFrEF patients and attempted to explore mechanistic relationship between hyperuricemia and HFrEF.MethodsHFrEF patients with hyperuricemia were selected from the National Inpatient Sample (NIS) 2016–2018 database and our Xianyang prospective cohort study. Demographics, cardiac risk factors, and cardiovascular events were identified. Network-based analysis was utilized to examine the relationship between recovery of LVEF and hyperuricemia, and we further elucidated the underlying mechanisms for the impact of hyperuricemia on HFrEF.ResultsAfter adjusting confounding factors by propensity score matching, hyperuricemia was a determinant of HFrEF [OR 1.247 (1.172–1.328); P < 0.001] of NIS dataset. In Xianyang prospective cohort study, hyperuricemia is a significant and independent risk factor for all-cause death (adjusted HR 2.387, 95% CI 1.141–4.993; P = 0.021), heart failure readmission (adjusted HR 1.848, 95% CI 1.048–3.259; P = 0.034), and composite events (adjusted HR 1.706, 95% CI 1.001–2.906; P = 0.049) in HFrEF patients. UA value at baseline was negatively correlated to LVEF of follow-ups (r = −0.19; P = 0.046). Cutoff UA value of 312.5 μmmol/L at baseline can work as a predictor of LVEF recovery during follow-up, with the sensitivity of 66.7%, the specificity of 35.1%, and the accuracy of 0.668 (95% CI, 0.561–0.775; P = 0.006). Moreover, gene overlap analysis and network proximity analysis demonstrated a strong correlation between HFrEF and Hyperuricemia.ConclusionLower baseline UA value predicted the LVEF recovery and less long-term adverse events in HFrEF patients. Our results provide new insights into underlying mechanistic relationship between hyperuricemia and HFrEF.https://www.frontiersin.org/articles/10.3389/fcvm.2022.853870/fulluric acidnetwork analysesheart failure with a reduced ejection fractionrecovery of left ventricular ejection fractionheart failure with recovery ejection fraction |
| spellingShingle | Xiqiang Wang Xiude Fan Xiude Fan Xiude Fan Qihui Wu Qihui Wu Jing Liu Linyan Wei Dandan Yang Xiang Bu Xiaoxiang Liu Aiqun Ma Tomohiro Hayashi Gongchang Guan Yu Xiang Shuang Shi Junkui Wang Jiansong Fang Uric Acid Predicts Recovery of Left Ventricular Function and Adverse Events in Heart Failure With Reduced Ejection Fraction: Potential Mechanistic Insight From Network Analyses Frontiers in Cardiovascular Medicine uric acid network analyses heart failure with a reduced ejection fraction recovery of left ventricular ejection fraction heart failure with recovery ejection fraction |
| title | Uric Acid Predicts Recovery of Left Ventricular Function and Adverse Events in Heart Failure With Reduced Ejection Fraction: Potential Mechanistic Insight From Network Analyses |
| title_full | Uric Acid Predicts Recovery of Left Ventricular Function and Adverse Events in Heart Failure With Reduced Ejection Fraction: Potential Mechanistic Insight From Network Analyses |
| title_fullStr | Uric Acid Predicts Recovery of Left Ventricular Function and Adverse Events in Heart Failure With Reduced Ejection Fraction: Potential Mechanistic Insight From Network Analyses |
| title_full_unstemmed | Uric Acid Predicts Recovery of Left Ventricular Function and Adverse Events in Heart Failure With Reduced Ejection Fraction: Potential Mechanistic Insight From Network Analyses |
| title_short | Uric Acid Predicts Recovery of Left Ventricular Function and Adverse Events in Heart Failure With Reduced Ejection Fraction: Potential Mechanistic Insight From Network Analyses |
| title_sort | uric acid predicts recovery of left ventricular function and adverse events in heart failure with reduced ejection fraction potential mechanistic insight from network analyses |
| topic | uric acid network analyses heart failure with a reduced ejection fraction recovery of left ventricular ejection fraction heart failure with recovery ejection fraction |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.853870/full |
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