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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Schlattmann, Peter / Tate, Jillian R. / Tsongalis, Gregory J.

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Increased homocysteine in heart failure: a result of renal impairment?

Nur Aksoy1 / Mehmet Aksoy2 / Mahmut Cakmak3 / Hasan Serdar Gergerlioglu4 / Vedat Davutoglu5 / Serdar Soydinc6 / Iclal Meram7








Corresponding author: Nur Aksoy, MD, University of Gaziantep, Vocational School of Higher Education for Health Services, Gaziantep 27310, Turkey Phone: +90-342-3601200, Fax: +90-342-3603928

Citation Information: Clinical Chemical Laboratory Medicine. Volume 44, Issue 11, Pages 1324–1329, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2006.245, November 2006

Publication History

June 11, 2006
August 25, 2006
Published Online:


Background: Hyperhomocysteinemia may constitute a risk factor for patients with severe heart failure. This study examines the relationship between plasma homocysteine concentration and left ventricular ejection fraction with renal function in heart failure patients free of coronary artery disease.

Methods: Left ventricular ejection fraction was documented in 62 patients with advanced heart failure who had no proven significant coronary artery stenosis. Glomerular filtration rate was measured using the Cockroft-Gault equation.

Results: Elevated homocysteine levels (≥15 μmol/L) were detected in 22 patients. Low glomerular filtration rate was observed in patients who had normal serum creatinine concentration. Homocysteine was strongly correlated with age, duration of disease, left ventricular ejection fraction, serum creatinine, and glomerular filtration rate. Statistically significant trends were observed across respective homocysteine quartiles. However, by multivariate regression, the strongest predictor of homocysteine was the glomerular filtration rate.

Conclusions: Impaired renal function leads to a diminished clearance rate, which can be a prominent pathophysiological mechanism in the elevation of homocysteine concentration in heart failure.

Clin Chem Lab Med 2006;44:1324–9.

Keywords: heart failure; hyperhomocysteinemia; renal function

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