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Higher prevalence of cardiac abnormalities including diastolic dysfunction in gout patients with low cardiovascular risk profile using cardiac MRI and echocardiography

Session Poster Session III - Friday 08:30 - 12:30

Speaker Edwin van Gorselen

Event : ESC Preventive Cardiology (Formerly EuroPrevent) 2015

  • Topic : preventive cardiology
  • Sub-topic : Risk Factors and Prevention
  • Session type : Poster Session

Authors : EOF Van Gorselen (Doetinchem,NL), MS Stob (Emmen,NL), J Van Es (Enschede,NL), IL Meek (Nijmegen,NL), LJ Wagenaar (Enschede,NL), HE Vonkeman (Enschede,NL), C Von Birgelen (Enschede,NL)

Authors:
EOF Van Gorselen1 , MS Stob2 , J Van Es3 , IL Meek4 , LJ Wagenaar3 , HE Vonkeman5 , C Von Birgelen6 , 1Slingeland Hospital, Cardiology - Doetinchem - Netherlands , 2Scheper Hospital, Cardiology - Emmen - Netherlands , 3Medical Spectrum Twente, Cardiology - Enschede - Netherlands , 4Radboud University Medical Centre, Rheumatology - Nijmegen - Netherlands , 5Medical Spectrum Twente, Rheumatology - Enschede - Netherlands , 6University of Twente - Enschede - Netherlands ,

Citation:

Purpose: Gout is associated with increased cardiovascular (CV) morbidity and mortality. To investigate gout-specific CV pathology a pilot study was performed to study cardiac abnormalities on echocardiography and MRI in low CV risk profile gout patients.
Methods: 10 male patients with chrystal proven gout were recruited from the Arthritis Center Twente CardioVascular Disease database. For inclusion only one of the following CV risk factors smoking, hypercholesterolemia or hypertension was allowed. Exclusion criteria were previous CV disease, age <18 or >75 years, kidney dysfunction, diabetes mellitus and BMI > 30.
Results: Median age was 61.5 years, median BMI was 26 kg/m2, no current smoking. 50% of patients had no CV risk factors. Three patients had elevated blood pressure; median SBP was 138 mmHg, DBP 79 mmHg. Two patients used statins. Median LDL was 2.9 mmol/L. Eight out of 10 patients used urate lowering medication and median serum urate was 0,59 mmol/L. One patient did not undergo echocardiography. 70% had diastolic dysfunction. One patient had asymptomatic atrial fibrillation, 4 left ventricular hypertrophy with concentric remodelling, 3 valvular calcification without significant stenosis and 1 had dilatation of the ascending aorta. Cardiac MRI showed no myocardial edema, but in one patient late gadolinium enhancement and in two regional wall motion abnormalities.
Conclusions: Low CV risk profile gout patients had substantial cardiac abnormalities on echocardiography and cardiac MRI, in particular diastolic dysfunction. The presence of gout-specific CV risk is suggested. Non-invasive cardiac imaging may be useful to detect early subclinical CV pathology.

LV function echocardiography

LV function MRI

2D EF (%)

55.4 (51.1-65.6)

LVEF (%)

59,5 (52.2-66.6)

3D EF(%)

57.5 (43.2-63.0)

RVEF (%)

57.3 (51.0-65.0)

LV mass/BSA (g/m2)

79,7 (50.6-101.2)

LV mass/BSA (g/m2)

48.5 (31.0-60.0)

Diastolic dysfunction grade (n=)

Normal

3

LAVI (ml/m2)

29,0 (19-35)

I

5

II

2

E/A ratio

0.87 (0.76-1.20)

LV: left ventricle, EF: ejection fraction, LAVI: left atrial volume index, RV: right ventricle

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