Left ventricular systolic dysfunction is an independent predictor of homocysteine in angiographically documented patients with or without coronary artery lesions

Abstract

Summary. Background: Elevated plasma homocysteine is a risk factor for coronary artery disease (CAD) and thromboembolic disorders that seems also to be associated with chronic heart failure. Objective: To evaluate the association between homocysteine and left ventricular dysfunction and to assess whether it is independent of CAD. Patients and methods: A prospective study evaluated this relationship in 709 patients referred for diagnostic coronary angiography, including 515 CAD and 194 patients without evidence of coronary artery lesions. Results: The homocysteine level was significantly higher in the 187 patients with a left ventricular ejection fraction (LVEF) dysfunction < 40% (P < 0.0001) than in those without ventricular dysfunction. LVEF, NYHA functional class II or III and CAD, stable angina and hypertension were clinical characteristics that influenced total homocysteine level in univariate analysis. Homocysteine was significantly associated with LVEF and N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) in univariate regression (r = -0.267, 95% CI -0.33 to -0.19, P < 0.0001, and r = 0.381, 95% CI 0.28-0.47, P < 0.0001, respectively) and in multiple regression (P = 0.0022 and P = 0.0001, respectively). Other determinants were creatinine and vitamin B 12 , but not folate. LVEF was a predictor of homocysteine > 15 lmol L )1 in the whole population (P for trend £ 0.0001) and in patients without documented CAD (P for trend = 0.0058). Conclusion: Our results showed an association of homocysteine with left ventricular systolic dysfunction and NT-pro-BNP that existed independently of documented CAD. Whether this association reflects a causative factor or a consequence of CHF and influences the prognosis of the disease remains an open question.

High Homocysteine Levels Predict the Recurrence of Atrial Fibrillation After Successful Electrical Cardioversion

“…It has been postulated in previous studies that Hcy is associated with left ventricular dysfunction and heart failure, which can also be connected to increased AF occurrence. [11][12][13] Still, based on available data it is not clear whether there is a causal relationship between elevated Hcy levels and atrial remodelling. It was postulated that activation of different MMPs can modulate extracellular matrix collagen disintegration, which can in turn cause the structural and hence electrical remodelling of human atria.…”

Methoxistasis: Integrating the Roles of Homocysteine and Folic Acid in Cardiovascular Pathobiology

“…Since heart failure is associated with structural and functional changes in the heart, multiple studies have examined the relationship between blood homocysteine level and cardiac structure and function. Several small clinical studies have shown an association of plasma homocysteine level with left ventricular ejection fraction [85,86,88], and with increased left ventricular mass and volumes [89]. Nasir and colleagues utilized magnetic resonance imaging to examine the correlation of regional left ventricular function to blood homocysteine level in 1178 participants of the Multi-Ethnic Study of Atherosclerosis [90].…”

Early incidence of occupational asthma among young bakers, pastry-makers and hairdressers: design of a retrospective cohort study

“…Our attention will also focus on the metabolism of folates, an area (which could play a role in asthma) that remains poorly explored to date. Most studies concerning methyl donors show their involvement in many inflammatory disorders (cardiovascular, neurodegenerative, autoimmune diseases...) [47,48], and some studies have suggested their involvement in the development of atopy. For them, a dietary deficiency of methionine, folate and other B vitamins are associated with a high risk of atopy [49].…”