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Homocysteine and P wave dispersion in patients with heart transplantation

Maurizio Acampa1, Pietro Enea Lazzerini, Francesca Guideri

  • 1Division of Internal Medicine, Department of Clinical Medicine and Immunological Sciences, University of Siena, Siena, Italy. M.Acampa@ao-siena.toscana.it

Clinical Transplantation
|November 3, 2009
PubMed

Insights

High homocysteine (HHcy) levels in heart transplant patients are linked to altered atrial electrical conduction, potentially increasing arrhythmia risk. This study investigated the association between homocysteine and cardiac electrical instability markers.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Transplantation Medicine

Background:

  • Hyperhomocysteinemia (HHcy) is a common finding in orthotopic heart transplantation (OHT) patients.
  • HHcy is a potential risk factor for atherothrombosis and may have pro-arrhythmogenic effects.
  • OHT patients have denervated hearts, making them unresponsive to autonomic influences.

Purpose of the Study:

  • To evaluate the correlation between homocysteine (Hcy) plasma levels and parameters of myocardial electric instability in OHT patients.
  • Investigated P wave dispersion (PWD), corrected QT interval (QTc), and QTc dispersion (QTcD) as indicators of electric instability.
  • Assessed these parameters in denervated hearts of OHT patients.

Main Methods:

  • Measured Hcy plasma levels, PWD, QTc, QTcD, and QTc dynamics in 32 OHT patients and 20 control subjects.
  • Compared electrical parameters between OHT patients and controls.
  • Analyzed correlations between Hcy levels and electrical parameters in OHT patients.

Main Results:

  • OHT patients exhibited significantly higher PWD and QTc intervals compared to controls.
  • OHT patients with HHcy showed higher PWD than those with normal Hcy levels.
  • Plasma Hcy levels significantly correlated with PWD in OHT patients, but not with QTc, QTcD, or QTc dynamics.

Conclusions:

  • HHcy appears to be associated with altered atrial electrical conduction in OHT patients.
  • This alteration may contribute to the elevated risk of cardiac arrhythmias in denervated hearts post-transplantation.
  • Further research is warranted to elucidate the mechanisms linking HHcy to arrhythmias in OHT recipients.
Abstract

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