2nd Department of Internal Medicine, Iuliu Hatieganu University of Medicineand Pharmacy, Cluj-Napoca, Romania.
Cardiol J. 2011;18(1):55-62.
Homocysteine is considered to be a risk factor, or an indicator of risk, for the development of cardiovascular disease. Little data is available on its significance in patients with previous myocardial infarction. The aim of our study was to assess the plasma level of homocysteine and its relationship with the severity of heart failure in patients with chronic myocardial infarction.
We studied 144 patients with previous myocardial infarction. Patients were divided into two groups according to the presence or absence of heart failure, as certified by clinical evidence of heart failure and by echocardiographic criteria for left ventricular systolic dysfunction.
Of the patients with prior myocardial infarction (144; 63.6 ± 9.6 years) included in the study, 65 had heart failure. The mean level of homocysteine was significantly higher in the heart failure group (18.9 mmol/L) than in the non-heart failure group (14.1 mmol/L; p ≤ 0.001). Our study demonstrated that there is a statistically significant correlation between homocysteine plasma levels and the severity of heart failure in patients with prior myocardial infarction. Homocysteine levels have proved to become higher with NYHA class progression. A significant cross-sectional correlation has been assessed between homocysteine and tissue Doppler echocardiography parameters.
Increased plasma homocysteine levels independently correlate with the severity of heart failure in patients with chronic myocardial infarction. We suggest that homocysteine can be used in clinical practice as a valuable heart failure risk marker in patients with chronic myocardial infarction.
同型半胱氨酸被认为是心血管疾病发展的风险因素或风险指标。关于其在既往心肌梗死患者中的意义的数据较少。我们的研究目的是评估慢性心肌梗死后患者血浆同型半胱氨酸水平及其与心力衰竭严重程度的关系。
我们研究了 144 例既往心肌梗死患者。根据心力衰竭的临床证据和左心室收缩功能超声心动图标准，将患者分为心力衰竭组和非心力衰竭组。
在纳入研究的 144 例既往心肌梗死患者（63.6±9.6 岁）中，65 例有心衰。心力衰竭组的同型半胱氨酸水平（18.9mmol/L）明显高于非心力衰竭组（14.1mmol/L；p≤0.001）。我们的研究表明，在既往心肌梗死患者中，同型半胱氨酸血浆水平与心力衰竭严重程度之间存在显著的统计学相关性。同型半胱氨酸水平随着 NYHA 分级的进展而升高。已经评估了同型半胱氨酸与组织多普勒超声心动图参数之间的横断面相关性。
升高的血浆同型半胱氨酸水平与慢性心肌梗死后心力衰竭的严重程度独立相关。我们建议，同型半胱氨酸可在临床实践中用作慢性心肌梗死患者心力衰竭的有价值的风险标志物。
