Effect of homocysteine on left ventricular structural and functional parameters in patients on programmed hemodialysis

• Published in: Terapevtic̆eskii arhiv Vol. 85; no. 3; pp. 90 - 93
• Main Authors: Kharlamova, U V, Il'icheva, O E
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) "Consilium Medicum" Publishing house 01.01.2013
• Subjects: Adult; Female; Heart Ventricles - chemistry; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; hemodialysis; homocysteine; Homocysteine - blood; Homocysteine - physiology; Humans; Hyperhomocysteinemia - physiopathology; Hypertrophy, Left Ventricular - blood; Hypertrophy, Left Ventricular - diagnostic imaging; Hypertrophy, Left Ventricular - physiopathology; left ventricular remodeling; Male; Middle Aged; Renal Dialysis - adverse effects; Structure-Activity Relationship; Ultrasonography; Ventricular Remodeling - physiology
• ISSN: 0040-3660; 2309-5342

To determine the effect of plasma homocysteine (Hc) on the structure and function of the left ventricle (LV) in patients treated by programmed hemodialysis. 109 patients on programmed hemodialysis were examined. Blood Hc levels were determined and echocardiography was performed in all the patients. In the patients on programmed hemodialysis, Hc concentrations were significantly higher than in apparently healthy individuals; there was a preponderance of mild (49.5%) and moderate (43.1%) hyperhomocysteinemia. LV hypertrophy was diagnosed in 90.8% of the patients. A positive relationship was found between the concentrations of Hc and the E/A ratio (r = 0.34; p = 0.05), isovolumetric relaxation time (IRT) (r = 0.32; p = 0.03), and LV mass (LVM) (r = 0.3; p = 0.05). Multivariate regression analysis indicated that the level of Hc had an independent impact on the E peak (R2 = 0.3; p = 0.05), LV relative wall thickness (RWT) (R2 = 0.38; p = 0.03), and LV IRT (R2 = 0.3; p = 0.06). Elevated plasma Hc levels were found to be related to LVM, LV RWT, LV IRT, E peak, and E/A ratio, suggesting that Hc had an unfavorable effect on the LV structure and function in patients on hemodialysis.