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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
PubMed

Insights

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.

Keywords:
cardiac biomarkerequinehearthyperhomocysteinemiaregurgitation

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