Lower urinary tract symptoms (LUTs) is well established as being an independent risk factor for cardiovascular disease (CVD). However, the association between structural heart disease and LUTs remains unclear. Echocardiography is the main examination to assess structural heart disease. Therefore, the current study aimed to investigate the relationship between LUTs and structural heart disease via application of echocardiography.

This single center, prospective cross sectional study included adult female patients with LUTs who had undergone echocardiography for suspected cardiac abnormalities from February to March 2021. Doppler echocardiography was implemented following a standard protocol recommended by the European Society of Cardiology. All the participants were asked to complete the questionnaires composing of general demographic information and International Prostate Symptom Score (IPSS) questionnaire. LUTs severity was categorized based on the IPSS. The Chi-squared test was used to compare the differences between mild and moderate to severe LUTs (defined as IPSS ≥ 8). Multi-variable logistic regression analyses adjusted for demographic covariates and comorbidities were conducted to determine whether moderate to severe LUTs was predictive of echocardiographic abnormalities. A two-sided p-value less than 0.05 was accepted as statistically significant.

Total 165 female patients (mean age 69.96 ± 10.20 years) were enrolled in the study. All the participants were categorized into two group based on the IPSS. Among the participants, 132 patients (80%) were found to have mild LUTs and 33 patients (20%) were found to have moderate to severe LUTs.

The prevalence of moderate to severe aortic regurgitation (AR) was significantly higher in patients with moderate to severe LUTs compared to those with mild LUTs (33.3% vs. 13.6%, p = 0.008). Other parameters did not differ significantly in patients with moderate to severe LUTs compared to those with mild LUTs. On multi-variable logistic regression analyses, moderate to severe LUTs could predict moderate to severe AR independently [odds ratio (OR) 3.56; 95% confidence interval (CI) 1.409-8.993, p = 0.007]. Furthermore, it was IPSS storage sub-score rather than voiding sub-score having significant association with moderate to severe AR (OR 1.285; 95% CI 1.111-1.486, p = 0.001).

Moderate to severe LUTs, especially storage symptoms, was an independent predictor for the co-existence of moderate to severe AR in female patients. This correlation may be concerned in clinical practice, urologists should recognize cardiac manifestations that develop in female patients coexisting with AR and moderate to severe LUTs. Early referral to cardiologist may provide collaborative treatment and improvement of general health for these patients.

Continence 2S2 (2022) 100349
DOI: 10.1016/j.cont.2022.100349