Background : The N-terminal pro-brain natriuretic peptide (NT-proBNP) level is a surrogate marker for elevated left ventricular filling pressure(LVFP), which is related to prognosis, in patients with acute heart failure (AHF pts). Hyperuricemia is known to be a poor prognostic factor in heart failure. Therefore, we investigated whether hyperuricemia affects the prediction power of NT-proBNP for elevated LVFP in AHF pts. Methods and Results: We analyzed routine laboratory findings including NT-proBNP and echocardiographic parameters in 80 hospitalized AHF pts including ischemic or nonischemic etiology (48 males, 64.9 짹 12.4 years old, 33 ischemic). Hyperuricemia (n= 41) was defined as > 7 mg/dL in male and > 6 mg/dL in female pts. In our study, median NT-proBNP was 5183.0 (1956.5 to 11174.5) pg/ml, mean uric acid was 6.9 짹 2.5 mg/dL and mean estimated glomerular filtration rate (eGFR) was 51.6 짹 27.3 %, respectively. The mean LV ejection fraction (LVEF) was 33.4 짹 15.3 % and early mitral inflow velocity to early diastolic mitral annular velocity (E/E���), indirect parameter for LVFP, was 21.9 짹 9.5. The eGFR (42.4 vs 65.3 %, p<0.001) and E/E��� (24.3 vs 19.7, p<0.05) were significantly different between hyperuricemic and normouricemic group, whereas LVEF and log NT-proBNP were not. The optimal cutoff value of NT-proBNP for the prediction of E/E���> 15 was 2456 pg/ml in all group (AUC 0.648, sensitivity 75%, specificity 55%, p<0.05), and 1670.5 pg/ml in normouricemic group (AUC 0.731, sensitivity 86.4%, specificity 63.6%, p<0.05). However, the prediction power of NT-proBNP was disappeared in hyperuricemic group (AUC 0.466, p=0.782). Conclusion: We found that hyperuricemia interfered the prediction power of NT-proBNP for elevated LVFP in AHF pts. Therefore, hyperuricemia should be considered in the prediction of elevated LVFP based on NT-proBNP levels in AHF pts.