Objective By observing the echocardiographic dimensions in the acute phase and the intercritical phase of gout, we planned to investigate the effect of acute gouty arthritis on cardiac function. Methods Patients with gout were enrolled from Jun 2019 to Apr 2021 in Department of Rheumatology, Zhongshan Hospital of Fudan University. They were classified into acute gout group and intercritical gout group according to different phases. Clinical data were collected and echocardiographic examination was completed within 1-3 days. Echocardiography was repeated in patients with acute attack 30 days later. Echocardiographic parameters of different groups or different phases in the same group were analyzed and compared. Results Finally, 69 male cases were enrolled. Among them, 32 were acute gout group and 37 were intercritical gout group. Compared with the intercritical gout group, the ejection fraction in the acute gout group decreased [60% (56%-64%) vs. 64% (62%-65%), Z=-2.814, P=0.005], and the left atrial area reduced [ (13±4) cm² vs. (16±3) cm², t=-4.146, P <0.001]. When serum uric acid was more than 480 µmol/L, the ejection fraction of acute gout group was lower than that of intercritical gout group [59% (55%-62%) vs. 64% (59%-70%), Z=-4.112, P<0.001], and the left atrial area was smaller [ (13±5) cm² /L vs. (17±3) cm² /L, t=-3.121, P=0.003). The echocardiographic parameters were similar among the two groups when serum uric acid was ≤480 μmol/L. The ejection fraction of patients with acute gout in remission stage was better than that in acute attack stage, but the difference was not statistically significant (P=0.78). Conclusion Acute gouty arthritis can decrease ejection fraction in male patients, particularly in patients with high uric acid level. Controlling gout attacks may help reduce the risk of cardiac dysfunction. [ABSTRACT FROM AUTHOR]