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Homocysteine and heart failure: an overview

Enrico Vizzardi1, Ivano Bonadei, Gregoriana Zanini

  • 1Department of Cardiology, University of Brescia, Brescia, Italy. enrico.vizzardi@tin.it

Recent Patents on Cardiovascular Drug Discovery
|January 20, 2009
PubMed

Insights

Elevated homocysteine (HCY) is linked to vascular disease and may cause congestive heart failure (CHF). Lowering HCY with B-vitamins might improve CHF outcomes, warranting further research.

Area of Science:

  • Cardiovascular Medicine
  • Biochemistry
  • Vascular Biology

Background:

  • Elevated plasma homocysteine (HCY) is a known risk factor for thrombotic and atherosclerotic vascular disease.
  • Hyperhomocysteinemia (HHCY) is independently associated with increased vascular disease risk.
  • HCY elevation is also a risk factor for congestive heart failure (CHF) in individuals without prior myocardial infarction.

Purpose of the Study:

  • To investigate the role of hyperhomocysteinemia (HHCY) as a potential etiological factor in congestive heart failure (CHF).
  • To explore the mechanisms by which elevated HCY may lead to cardiac dysfunction and remodeling.
  • To assess the potential of HCY-lowering therapy for improving CHF markers and outcomes.

Main Methods:

  • Review of existing studies and patents linking HCY to vascular disease and CHF.
  • Analysis of animal studies demonstrating HHCY-induced cardiac dysfunction and remodeling.
  • Consideration of preliminary intervention trial data on HCY-lowering therapy.

Main Results:

  • Experimental HHCY in animals induces systolic and diastolic dysfunction and increases BNP expression.
  • Hyperhomocysteinemic animals show adverse cardiac remodeling with increased collagen.
  • Preliminary data suggest HCY-lowering therapy may improve clinical and laboratory markers of CHF.

Conclusions:

  • Hyperhomocysteinemia (HHCY) may be a potential etiological factor in congestive heart failure (CHF).
  • Further research is needed to elucidate the precise pathomechanisms of HHCY in CHF.
  • Larger intervention trials are required to determine if B-vitamin supplementation improves clinical outcomes in CHF patients.

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