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Homocysteine levels in patients with heart failure with preserved ejection fraction
Ertuğrul Okuyan1, Ahmet Uslu, Mehmet Akif Cakar
1Bagcilar Education and Research Hospital, Istanbul, Turkey. dreokuyan@hotmail.com
Insights
Elevated homocysteine (HCY) levels are common in patients with heart failure with preserved ejection fraction. This finding suggests hyperhomocysteinemia may play a role in diastolic heart failure.
Area of Science:
- Cardiology
- Biochemistry
Background:
- Elevated homocysteine (HCY) levels are linked to cardiovascular disease risk.
- Hyperhomocysteinemia is observed in chronic heart failure (CHF) and may contribute to adverse cardiac remodeling and impaired pump function.
Purpose of the Study:
- To investigate homocysteine (HCY) levels in patients diagnosed with diastolic heart failure characterized by preserved left ventricular ejection fraction (LVEF).
Main Methods:
- A prospective study involving 68 hospitalized heart failure patients and 40 healthy controls.
- Heart failure with preserved LVEF was defined as LVEF ≥ 50% based on Framingham criteria.
- Exclusion criteria included regional wall motion abnormalities, atrial fibrillation, and renal failure.
Main Results:
- Heart failure patients exhibited significantly higher mean total fasting homocysteine (HCY) concentrations (16.9 μmol/l) compared to controls (10.15 μmol/l).
- Multiple regression analysis revealed independent associations between hyperhomocysteinemia and NT-proBNP, hs-CRP, E/A ratio, and HbA1C.
Conclusions:
- Hyperhomocysteinemia is prevalent in individuals with heart failure with preserved ejection fraction.
- Further large-scale research is required to elucidate the pathogenic mechanisms and impact of hyperhomocysteinemia on the natural course of heart failure.
Objectives:
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.
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