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Plasma Homocysteine Concentrations in Horses with Left-Sided Valvular Heart Disease
Patricia Egli1, Elizabeth Williams Louie2, Martina Stirn3
1Equine Department, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland.
Animals : an Open Access Journal From MDPI
|August 13, 2026
Summary
Homocysteine (HCY) is a stable biomarker in equine blood samples under various storage conditions. However, plasma HCY is not associated with left-sided valvular heart disease in horses.
Area of Science:
- Veterinary Clinical Pathology
- Equine Cardiology
- Biomarker Validation
Background:
- Homocysteine (HCY) is a biomarker in human medicine linked to endothelial dysfunction and cardiovascular disease.
- An established HCY assay for humans has been adapted and validated for horses, with reference ranges established.
- Further evaluation of the HCY assay's stability and its association with cardiac conditions in horses is warranted.
Purpose of the Study:
- To evaluate the analytical performance of the homocysteine assay in equine samples.
- To assess the stability of homocysteine in whole blood and plasma under various storage conditions and anticoagulants.
- To investigate the association between plasma homocysteine concentrations and echocardiographic findings in horses with left-sided valvular regurgitation.
Main Methods:
- Analyzed short-term stability (24h at 4°C and room temperature), long-term stability (2 years), anticoagulant effects (serum, lithium heparin, EDTA, no additives), and freeze-thaw cycles (5x).
- Investigated associations between plasma homocysteine concentrations ([HCY]p) and echocardiographic variables in 169 horses with left-sided valvular regurgitation.
Main Results:
- Homocysteine concentrations remained stable in whole blood at room temperature for at least 4 hours, and longer in plasma stored at 4°C.
- Serum, lithium heparin, and EDTA were suitable anticoagulants for HCY measurement.
- Plasma HCY showed a slight increase with long-term frozen storage but was unaffected by up to five freeze-thaw cycles.
- Age and plasma creatinine were positively associated with higher [HCY]p in horses.
- No significant association was found between [HCY]p and cardiac size, function, or severity of valvular regurgitation.
Conclusions:
- The homocysteine assay is reliable for equine samples with appropriate handling and storage.
- Homocysteine is not a useful biomarker for diagnosing or monitoring left-sided valvular heart disease in horses.
- Further research is needed to explore other potential roles of homocysteine in equine health.
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