Increased homocysteine in heart failure: a result of renal impairment?
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.
Aksoy
Nur
N
Department of Medical Laboratory, Vocational School of Higher Education for Health Services, University of Gaziantep, Gaziantep, Turkey. naksoy@gantep.edu.tr
Aksoy
Mehmet
M
Cakmak
Mahmut
M
Gergerlioglu
Hasan Serdar
HS
Davutoglu
Vedat
V
Soydinc
Serdar
S
Meram
Iclal
I
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
D006710:Homocysteine; D003401:Creatine