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Homocysteine, left ventricular dysfunction and coronary artery disease: is there a link?

Gian Paolo Rossi1, Teresa Maria Seccia, Achille Cesare Pessina

  • 1Department of Clinical and Experimental Medicine (DMCS-Internal Medicine 4), School of Medicine, University of Padua, Padua, Italy. gianpaolo.rossi@unipd.it

Clinical Chemistry and Laboratory Medicine
|November 10, 2007
PubMed

Insights

High plasma homocysteine (tHcy) levels predict cardiovascular death in hypertensive patients. This finding, linked to reduced left ventricular function, suggests potential benefits of tHcy-lowering treatments in coronary artery disease.

Area of Science:

  • Cardiology
  • Biochemistry
  • Clinical Research

Background:

  • Plasma total homocysteine (tHcy) is implicated in coronary artery disease (CAD).
  • Previous studies suggest a link between tHcy and cardiovascular outcomes.
  • The precise role of tHcy in hypertensive patients with CAD requires further elucidation.

Purpose of the Study:

  • To investigate the association between tHcy levels and cardiovascular mortality in hypertensive patients with CAD.
  • To explore the relationship between tHcy and left ventricular (LV) function.
  • To determine if tHcy impacts cardiovascular risk independently of established CAD markers.

Main Methods:

  • Analysis of data from the GENICA (Genetic and Environmental factors In Coronary Atherosclerosis) study.
  • Assessment of tHcy levels in relation to cardiovascular mortality and LV ejection fraction.
  • Statistical analysis to control for confounding factors like CAD severity and history of myocardial infarction.

Main Results:

  • High tHcy levels were a significant predictor of cardiovascular mortality in hypertensive patients, independent of CAD and myocardial infarction history.
  • tHcy was not associated with the extent of coronary atherosclerosis.
  • An inverse relationship was observed between tHcy levels and left ventricular ejection fraction, indicating impaired systolic function.

Conclusions:

  • Elevated tHcy is an independent risk factor for cardiovascular mortality in hypertensive CAD patients.
  • The inverse association between tHcy and LV function may explain its link to heart failure risk.
  • Further research into tHcy's effect on LV function is warranted to explore therapeutic strategies for CAD.

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