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1 Abteilung für Klinische Chemie und Laboratoriumsmedizin/Zentrallabor,2 Klinik für Innere Medizin III, and3 Institut für Medizinische Biometrie, Epidemiologie und Medizinische Informatik, Universitätsklinikum des Saarland, Homburg/Saar, Germany;
aaddress correspondence to this author at: Abteilung für Klinische Chemie und Laboratoriumsmedizin/Zentrallabor, Universitätsklinikum des Saarland, D-66421 Homburg/Saar, Germany; fax 49-6841-1630703, e-mail kchwher@uniklinik-saarland.de
| The first 20% of the full text of this article appears below. |
Chronic heart failure (CHF) is a major public health problem causing considerable morbidity and mortality (1)(2)(3). Prevention of CHF by identifying risk factors is therefore a major issue. Previous studies found that hypertension, smoking, diabetes mellitus, obesity, and advancing age are the most important risk factors for CHF (4). Recently, plasma homocysteine (Hcy) has been suggested as a newly recognized risk factor (5)(6). However, there are no data regarding the association between Hcy and various objective as well as subjective measures of CHF. The demonstration of such relationships would help to clarify the role of hyperhomocysteinemia in CHF. We hypothesized that plasma Hcy is associated with clinical and echocardiographic signs of CHF as well as with N-terminal pro-brain natriuretic peptide (NT-proBNP), suggesting a relationship between Hcy and the severity of CHF. Accordingly, we investigated the relationships of plasma Hcy with serum NT-proBNP and clinical and echocardiographic indices of CHF in patients and in controls.
For this study, 95 patients with systolic CHF and 12 healthy persons without cardiac diseases were interviewed and examined by the same 2 experienced cardiologists, who were blinded to the study. All participants had a medical history, physical examination, venous blood sampling, 6-min walking test (6-MWT), electrocardiography, and echocardiography. Eighty-two patients underwent a cardiac catheterization according to the American Heart Association guidelines (7). Additionally, 37 patients performed a symptom-limited bicycle exercise test (Ergoline cardio-systems) with gas-exchange analysis (MedGraphics CPX/D spiroergometry system; Medical Graphics Corporation) to determine maximum oxygen uptake (VO2max). Informed consent was obtained from all participants, and the study protocol was approved by the Institutional Review Board.
Nonfasting venous blood samples (plasma and serum) were drawn during the office visits
The following articles in journals at HighWire Press have cited this article:
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  K. S. Moshal, S. M. Tipparaju, T. P. Vacek, M. Kumar, M. Singh, I. E. Frank, P. K. Patibandla, N. Tyagi, J. Rai, N. Metreveli, et al. Mitochondrial matrix metalloproteinase activation decreases myocyte contractility in hyperhomocysteinemia Am J Physiol Heart Circ Physiol, August 1, 2008; 295(2): H890 - H897. [Abstract] [Full Text] [PDF]
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 M. Herrmann, O. Taban-Shoma, U. Hubner, A. Pexa, H. Kilter, N. Umanskaya, R. Hans Straub, M. Bohm, and W. Herrmann Hyperhomocysteinemia and Myocardial Expression of Brain Natriuretic Peptide in Rats Clin. Chem., April 1, 2007; 53(4): 773 - 780. [Abstract] [Full Text] [PDF]
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 M. Herrmann, S. Muller, I. Kindermann, L. Gunther, J. Konig, M. Bohm, and W. Herrmann Plasma B vitamins and their relation to the severity of chronic heart failure Am. J. Clinical Nutrition, January 1, 2007; 85(1): 117 - 123. [Abstract] [Full Text] [PDF]
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