Predictive value of high homocysteine on deterioration of cardiac function in patients with heart failure with reduced ejection fraction

doi:10.3877/cma.j.issn.2095-9133.2021.02.004

Abstract

Abstract:

Objective

To investigate the predictive value of high homocysteine (HHcy) on deterioration of cardiac function in patients with heart failure with reduced ejection fraction (HfrEF).

Methods

The HFrEF patients (n=115, 75 males and 40 females) admitted to the Fifth Affiliated Hospital of Sun Yat-sen University from January 2019 to June 2019 were enrolled in our study. and another 100 patients(67 males and 33 females)without heart disease were selected as the control group. The serum levels of Hcy, NT-proBNP and Cr of all patients were retrospectively analyzed. We divided HFrEF patients into two groups by serum Hcy level>15 mol/L: high homocysteine group and low Hcy group. Clinical follow-up of these patients was carried out to analyze the relationship between serum HHcy level and the readmission rate.

Results

The serum levels of Hcy, NT-proBNP and Cr in the HFrEF group were significantly higher than those in the control group (P<0.01). The readmission rate of HHcy group was significantly higher than LHcy group (P<0.05).

Conclusion

HFrEF patients have higher serum levels of Hcy than that of control group, and HHcy level affects the readmission rate, which can be used to assess the prognosis for HFrEF patients.

Key words: Homocysteine, Heart failure with reduced ejection fraction, Readmission rate

Ani Wang, Yingdong Ma, Liang Wang, Liang Ma, Lizi Jin. Predictive value of high homocysteine on deterioration of cardiac function in patients with heart failure with reduced ejection fraction[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2021, 07(02): 83-85.

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Figures/Tables 2

References 14

1	Savarese G，Lund LH，Global Public Health Burden of Heart Failure，et al.Global public health burden of heart failure[J]．Card Fail Rev，2017，3(1)：7-11.
2	Dokainish H，Teo K，Zhu J，et al.Global mortality variations in patients with heart failure：results from the International congestive heart failure(INTER-CHF)prospective cohort study[J]．Lancet Glob Health，2017，5(7)：e665-e672.
3	Maurer M，Burri S，de Marchi S，et al.Plasma homocysteine and cardiovascular risk in heart failure with and without cardiorenal syndrome[J]．Int J Cardiol，2010，141(1)：32-38.
4	Vasan RS，Beiser A，D’Agostino RB.Plasma homocysteine and risk for congestive heart failure in adults without prior myocardial infarction[J]．JAMA，2003，289(10)：1251-1257.
5	Strauss E，Supinski W，Radziemski A，et al.Is hyperhomocysteinemia a causal factor for heart failure？the impact of the functional variants of MTHFR and PON1 on ischemic and non-ischemic etiology[J]．Int J Cardiol，2017(228)：37-44.
6	Agoston-Coldea L，Mocan T，Gatfosse M，et al.Plasma homocysteine and the severity of heart failure in patients with previous myocardial infarction[J]．Cardiol J，2011，18(1)：55-62.
7	Herrmann M，Taban-Shomal O，Hubner U，et al.A review of homocysteine and heart failure[J]．Eur J Heart Fail，2006，8(6)：571-576.
8	Fournier P，Fourcade J，Roncalli J，et al.Homocysteine in chronic heart failure[J]．Clin Lab，2015，61(9)：1137-1145.
9	Wang X，Cui L，Joseph J，et al.Homocysteine induces cardiomyocyte dysfunction and apoptosis through p38 MAPK-mediated increase in oxidant stress[J]．J Mol Cell Cardiol，2012. 52(3)：753-760.
10	Vacek TP，Vacek JC，Tyagi N，et al.Autophagy and heart failure：a possible role for homocysteine[J]．Cell Biochem Biophys，2012，62(1)：1-11.
11	解智慧，姚丹林，秦俭．同型半胱氨酸水平与急性心力衰竭的相关性研究[J]．中国医刊，2016，51(10)：36-38.
12	Pang X，Liu J，Zhao J，et al.Homocysteine induces the expression of C-reactive protein via NMDAr-ROS-MAPK-NF-κB signal pathway in rat vascular smooth muscle cells[J]．Atherosclerosis，2014，236(1)：73-81.
13	Wang X，Cui L，Joseph J，et al.Homocysteine induces cardiomyocyte dysfunction and apoptosis through p38 MAPK-mediated increase in oxidant stress[J]．J Mol Cell Cardiol，2012，52(3)：753-760.
14	Iqbal NS，Wu Y，Hazen S，et al.Elevated plasma homocysteine identifies patients with chronic heart failure at increased cardiovascular risk[J]．Journal of Cardiac Failure，2012，18(8)：S87.

组别	NT-proBNP(pg/mL)	Cr(μmol/L)	Hcy(mol/L)	再入院率(%)
心衰组	6 300±337	166±45	18.57±4.91	39.00
对照组	110±64	37±12	10.89±5.13	1.00
χ²	19.13	11.32	9.87	12.35
P值	<0.05	<0.05	<0.05	<0.05

组别	NT-proBNP(pg/mL)	Cr(μmol/L)	Hcy(mol/L)	再入院率(%)
心衰组	6 300±337	166±45	18.57±4.91	39.00
对照组	110±64	37±12	10.89±5.13	1.00
χ²	19.13	11.32	9.87	12.35
P值	<0.05	<0.05	<0.05	<0.05

组别	NT-proBNP(pg/mL)	Cr(μmol/L)	再入院率(%)
HHcy组	17 600±860	6 300±337	28.50
LHcy组	181±47	166±45	11.70
χ²	29.97	18.35	12.61
P值	<0.01	<0.05	<0.05

组别	NT-proBNP(pg/mL)	Cr(μmol/L)	再入院率(%)
HHcy组	17 600±860	6 300±337	28.50
LHcy组	181±47	166±45	11.70
χ²	29.97	18.35	12.61
P值	<0.01	<0.05	<0.05

[1]	Keying Xu, Qifeng Gui, Yunmei Yang. Association of serum cystatin C and homocysteine with leukoaraiosis in elderly population [J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2020, 13(01): 34-38.
[2]	Jin Yang, Hongyan Wang, Chunmei Ying. Analysis of serum folic acid level and its influencing factors after stable folic acid supplementation in pregnant women [J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2022, 18(05): 553-561.
[3]	Xuyi Liu, Qi Qin, Yalan Xin, Yanqiang Lu, Jifang Hu. Correlation analysis of serum homocysteine concentration with C677T polymorphism of MTHFR gene and red blood cell folate level at different trimesters of pregnancy [J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2020, 16(03): 362-367.
[4]	Tongfei Wu, Yuan Ding, Xiyuan Li, Yupeng Liu, Dongxiao Li, Jinqing Song, Mengqiu Li, Xiang Wang, Zijiang Zhao, Yaping Qin, Yanling Yang. Maternal vitamin B₁₂ deficiency and infants with secondary methylmalonic aciduria [J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2017, 13(01): 39-45.
[5]	Ting Liu, Xiaoling Wu, Mingfu Yang. Effects of folic acid combined with mecobalamin on oxidative stress, inflammatory factors and lung functions in patients with stable chronic obstructive pulmonary disease complicated with hyperhomocysteinemia [J]. Chinese Journal of Lung Diseases(Electronic Edition), 2020, 13(01): 59-62.
[6]	Song Li, Chenchen Zhang, Shuangshuang Song. Peripheral blood detection of EMMPRIN, ADMA, Hcy, MMPs, Treg and Th17 cells in patients with h-type hypertension complicated with coronary heart disease [J]. Chinese Journal of Cell and Stem Cell(Electronic Edition), 2019, 09(04): 206-210.
[7]	Hui Pang, Zhenkun Zong, Qiang Fu, Qiumei Cao, Lin Hao. Homocysteine for the risk of recurrent stroke in patients with stroke and hypertension [J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2019, 05(03): 134-139.
[8]	Shuzhen Wang, Hongsheng Wang, Lizhi Wang, Yingjie Li. Mechanism of hyperhomocysteinemia and its pathological significance [J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2019, 09(02): 117-120.
[9]	Hui Pang, Zhenkun Zong, Qiang Fu, Yi Liu, Lin Hao. Homocysteine for the risk of recurrent stroke in patients with stroke and hypertension [J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2019, 09(02): 69-74.
[10]	Caimei Li, Xiaochun Ding. Serum vitamin B12 and brain development levels in small for gestational age infants [J]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(05): 370-375.
[11]	Yao Lin, Xiaoling Huang, Zhaoxia He, Boyong Mou, Yan Mou. The predictive value of plasma homocysteine for coronary artery disease in female patients with hypertension [J]. Chinese Journal of Diagnostics(Electronic Edition), 2022, 10(01): 48-52.
[12]	Zhiqiang Sheng, Yanran Yuan, Bing Zhao. Diagnostic features of cb1C-type mthylmalonic acidemia with homocysteinemia and literature review [J]. Chinese Journal of Diagnostics(Electronic Edition), 2017, 05(04): 281-284.
[13]	Xiaoling Lu, Guangyue Qin, Qingdong Huang, Tingyu Tang, Jianzong Du. Relationship between HCY and cognitive function in elderly patients with severe obstructive sleep apnea syndrome [J]. Chinese Journal of Geriatrics Research(Electronic Edition), 2019, 06(02): 40-43.
[14]	Yanping Wu, Xiaobei Liu, Gongchun Huang, Huihui Gao, Qinfen Shu. Plasma homocysteine levels and related factors in urban and rural populations in Pinghu of Zhejiang Province [J]. Chinese Journal of Geriatrics Research(Electronic Edition), 2018, 05(04): 25-28.
[15]	Xi Yan, Junkui Shang, Fengyu Wang, Xiaoming Qin, Xuejing Huo, Ruijie Liu, Jinlong Zou, Jiewen Zhang. Association between homocysteine, coagulation-fibrinolysis parameters and cerebral small vessel disease [J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2022, 16(01): 27-31.

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