Effect of acute hyperhomocysteinemia on coronary flow reserve in healthy adults.
BACKGROUND
B-mode ultrasound studies indicate that hyperhomocysteinemia is associated with preclinical structural and functional arterial abnormalities. This study was designed to evaluate the effect of elevated plasma homocysteine levels on coronary flow reserve (CFR).


METHODS
A total of 20 healthy subjects aged 41 +/- 7 years were studied on 2 separate days, a week apart, before and after methionine load (100 mg/kg of body weight) or placebo in a double-blind crossover study. At each visit, homocysteine levels were measured by high performance liquid chromatography and CFR was determined by transthoracic Doppler echocardiography.


RESULTS
After methionine load, plasma homocysteine increased from 10.7 +/- 2.8 mumol/L to 30.4 +/- 5.1 mumol/L ( P < .0001) and CFR decreased from 3.0 +/- 0.4 to 2.3 +/- 0.3 ( P < .001). CFR was inversely related to postload homocysteine levels ( r = -0.21, P = .02). After placebo, there was no change in CFR.


CONCLUSIONS
In asymptomatic adults, acute hyperhomocysteinemia is associated with a significant reduction in CFR.
Ascione
Luigi
L
Division of Cardiology and Clinical Analysis Laboratory, S. Maria di Loreto Hospital, Naples, Italy. luigi.ascione20@tin.it
De Michele
Mario
M
Accadia
Maria
M
Rumolo
Salvatore
S
Sacra
Cosimo
C
Alberta Ortali
Vittoria
V
Inserviente
Luciano
L
Petti
Maria
M
Russo
Giovanna
G
Tuccillo
Bernardino
B
D000208:Acute Disease; D000328:Adult; D001783:Blood Flow Velocity / Q000187:drug effects; D003326:Coronary Circulation / Q000187:drug effects*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000187:drug effects*; D018592:Cross-Over Studies; D015150:Echocardiography, Doppler; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008715:Methionine / Q000008:administration & dosage* / Q000097:blood / Q000494:pharmacology; D010919:Placebos
D010919:Placebos; D006710:Homocysteine; D008715:Methionine