Cardiac allograft vascular disease after orthotopic heart transplantation: methylenetetrahydrofolate reductase gene polymorphism C677T does not account for rapidly progressive forms.
BACKGROUND
Recently, homocysteine (HCY) levels have been suggested to be a risk factor in cardiac allograft vascular disease (CAVD). As plasma levels are partially under genetic control, we investigated the influence of the methylenetetrahydrofolate reductase (MTHFR) polymorphism on HCY levels and development of CAVD in heart transplant (HTX) recipients.


METHODS
Genotyping and assessment of fasting HCY levels were performed in a cohort of 146 HTX recipients and correlated to the onset and progression of CAVD, assessed by serial angiography.


RESULTS
Actuarial freedom from CAVD did not differ significantly between the genotypes. However, patients positive for CAVD presented with higher HCY levels than CAVD-negative individuals (21.0+/-9.4 vs. 18.2+/-6.6 micromol/L, P=0.046).


CONCLUSIONS
There is some evidence that plasma HCY might be involved in development of CAVD. However, polymorphism of the MTHFR gene could not be shown to be related to severity of allograft vascular disease.
Pethig
K
K
Department of Cardiovascular and Thoracic Surgery, Hannover Medical School, Germany. klaus.pethig@thg.mh-hannover.de
Hoffmann
A
A
Heublein
B
B
Timke
A
A
Gross
G
G
Haverich
A
A
D000328:Adult; D000483:Alleles; D003327:Coronary Disease / Q000209:etiology / Q000235:genetics* / Q000503:physiopathology; D005260:Female; D006084:Graft Rejection / Q000235:genetics; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D042965:Methylenetetrahydrofolate Reductase (NADPH2); D008875:Middle Aged; D000587:Oxidoreductases Acting on CH-NH Group Donors / Q000235:genetics*; D011110:Polymorphism, Genetic; D014184:Transplantation, Homologous
D000587:Oxidoreductases Acting on CH-NH Group Donors; D042965:Methylenetetrahydrofolate Reductase (NADPH2)