Homocysteine levels in patients with heart failure with preserved ejection fraction.
OBJECTIVE
Increased homocysteine (HCY) levels are associated with an increased risk of cardiovascular disease. Plasma HCY is increased in chronic heart failure (CHF) patients, and previous studies suggest that hyperhomocysteinemia causes adverse cardiac remodeling and affects pump function. We aimed to evaluate the HCY levels in patients with diastolic heart failure with preserved left ventricular ejection fraction (LVEF).


METHODS
We prospectively studied 68 patients (39 females and 29 males) who were hospitalized for symptomatic heart failure, as well as 40 age- and sex-matched healthy subjects who comprised the control group. CHF was diagnosed in all cases based on Framingham diagnostic criteria. CHF with preserved LVEF was defined as cases with CHF with an LVEF of 50% or more. Patients with regional left ventricular wall motion abnormalities, atrial fibrillation, and renal failure were excluded.


RESULTS
The mean age was 65.5 ± 9.6 years in the heart failure group and 65.2 ± 9.7 years in the control group. The mean LVEF was 59.8 ± 5.3 in the heart failure group and 61.4 ± 5.2 in the control group. The mean total fasting HCY concentrations were significantly higher in patients with heart failure (16.9 ± 5.27 μmol/l vs. 10.15 ± 3.49 μmol/l, respectively; p < 0.001). Multiple regression analysis indicated that NT-proBNP, hs-CRP, E/A ratio, and HbA1C were independently associated with hyperhomocysteinemia.


CONCLUSIONS
Our results suggest that hyperhomocysteinemia is prevalent in heart failure with preserved ejection fraction. Larger scale studies are needed to clarify its pathogenic mechanisms and effects on the natural history of heart failure.
Okuyan
Ertuğrul
E
Bagcilar Education and Research Hospital, Istanbul, Turkey. dreokuyan@hotmail.com
Uslu
Ahmet
A
Cakar
Mehmet Akif
MA
Sahin
Irfan
I
Onür
Imran
I
Enhos
Asım
A
Biter
Halil Ibrahim
HI
Cetin
Sükrü
S
Dinçkal
Mustafa Hakan
MH
D000368:Aged; D005260:Female; D054144:Heart Failure, Diastolic / Q000453:epidemiology* / Q000378:metabolism / Q000503:physiopathology; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000453:epidemiology* / Q000378:metabolism; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011654:Pulmonary Edema / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology; D012307:Risk Factors; D013318:Stroke Volume / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology
D006710:Homocysteine