title: Hyperhomocysteinemia and cardiovascular risks in hemodialysis patients.
abstract: The risk of premature and progressive occlusive vascular disease is high in chronic uremic patients, and it accounts for more than 40% of the mortality in dialysis patients. End stage renal failure (ESRF) patients exhibit elevated plasma homocystein levels, about four fold as much as those in the controls, and it is now considered as a causative factor for increased risk of cardiovascular death among these patients. The aim of this study was to evaluate the relationship of total plasma homocysteine level and echocardiographic abnormalities as a surrogate of cardiac disease outcome in hemodialysis patients. 123 adult patients on maintenance hemodialysis and having echocardiography done during January till November 2006 were enrolled in this cross-sectional study. Plasma homocysteine level was directly related to the presence of aortic regurgitation r= 0.27 P= 0.009. There were negative correlations between ejection fraction (EF), left ventricular systolic dimension (LV.S) (r= - 0.71, P= 0.0001), left ventricular diastolic dimension (LV.D) (r= -0.23 p= 0.01) and age (r= - 0.021 P= 0.02). In conclusion we did not find the paradoxical reverse epidemiology in our patients and plasma total homocysteine level was in direct correlation with cardiac risk factors such as left ventricular mass index and aortic regurgitation.
authors.affiliation: Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Mohammad Mahdi
authors.initials: MM
authors.lastname: Sagheb
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Ostovan
authors.forename: Zahra
authors.initials: Z
authors.lastname: Sohrabi
authors.forename: Elham
authors.initials: E
authors.lastname: Atabati
authors.forename: Ghanbar Ali
authors.initials: GA
authors.lastname: Raisjalai
authors.forename: Jamshid
authors.initials: J
authors.lastname: Roozbeh
mesh_terms: D000328:Adult; D001022:Aortic Valve Insufficiency / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D015150:Echocardiography, Doppler; D018618:Echocardiography, Doppler, Color; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000150:complications*; D007492:Iran; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D006435:Renal Dialysis / Q000009:adverse effects*; D018570:Risk Assessment; D012307:Risk Factors; D013318:Stroke Volume; D015854:Up-Regulation; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D006710:Homocysteine