Hyperuricemia in severe pulmonary hypertension

Study objective: Hyperuricemia occurs frequency in patients with myeloproli ferative and lymphoproliferative disorders and in patients rrith congenital heart disease associated with polycythemia. Whether hyperuricemia is commo n in patients with severe pulmonary hypertension is not known. Design, patients, measurements: In the Pulmonary Hypertension Center at the University of Colorado Health Sciences Center between September 1991 and A ugust 1997, 442 consecutive patients were evaluated with light heart cathet erization; 191 patients also had a measurement of the serum uric acid (UA) in close temporal proximity to the hemodynamic evaluation. Results: Of the 191 patients with a complete data set, 99 patients had prim ary pulmonary hypertension (PPH) and 92 had secondary pulmonary hypertensio n, For the entire cohort rrith severe pulmonary hypertension (n = 191), the re was a positive correlation between the natural logarithm of the serum UA (InUA) and the mean right atrial pressure (RAP; r = 0.41; p < 0.001). When analyzed separately, the correlation between InUA and RAP was stronger in the patients with PPH (r = 0.612; p < 0.001), This correlation cannot be ex plained br diuretic use or impaired hepatocellular function. Neither mean p ulmonary artery pressure nor cardiac output was as well con elated with the RAP when compared with the InUA. Some patients with PPH had serum UA measu rements repeated during treatment with chronic IV prostacyclin infusion. El even of these 18 patients (61%) demonstrated a decrease in serum UA during prostacyclin treatment. Conclusion: There is a positive correlation between the RAP elevation and t he serum UA levels in patients with PPH. Serum UA levels drop in some, but not all PPH patients during chronic prostacyclin infusion therapy.