title: Increased homocysteine in heart failure: a result of renal impairment?
abstract: BACKGROUND
  Hyperhomocysteinemia may constitute a risk factor for patients with severe heart failure. This study examines the relationship between plasma homocysteine concentration and left ventricular ejection fraction with renal function in heart failure patients free of coronary artery disease.
  
  
  METHODS
  Left ventricular ejection fraction was documented in 62 patients with advanced heart failure who had no proven significant coronary artery stenosis. Glomerular filtration rate was measured using the Cockroft-Gault equation.
  
  
  RESULTS
  Elevated homocysteine levels (>or=15 micromol/L) were detected in 22 patients. Low glomerular filtration rate was observed in patients who had normal serum creatinine concentration. Homocysteine was strongly correlated with age, duration of disease, left ventricular ejection fraction, serum creatinine, and glomerular filtration rate. Statistically significant trends were observed across respective homocysteine quartiles. However, by multivariate regression, the strongest predictor of homocysteine was the glomerular filtration rate.
  
  
  CONCLUSIONS
  Impaired renal function leads to a diminished clearance rate, which can be a prominent pathophysiological mechanism in the elevation of homocysteine concentration in heart failure.
authors.affiliation: Department of Medical Laboratory, Vocational School of Higher Education for Health Services, University of Gaziantep, Gaziantep, Turkey. naksoy@gantep.edu.tr
authors.forename: Nur
authors.initials: N
authors.lastname: Aksoy
authors.forename: Mehmet
authors.initials: M
authors.lastname: Aksoy
authors.forename: Mahmut
authors.initials: M
authors.lastname: Cakmak
authors.forename: Hasan Serdar
authors.initials: HS
authors.lastname: Gergerlioglu
authors.forename: Vedat
authors.initials: V
authors.lastname: Davutoglu
authors.forename: Serdar
authors.initials: S
authors.lastname: Soydinc
authors.forename: Iclal
authors.initials: I
authors.lastname: Meram
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003401:Creatine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D013318:Stroke Volume; D016277:Ventricular Function, Left
chemical_list: D006710:Homocysteine; D003401:Creatine