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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.


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Homocysteine, left ventricular dysfunction and coronary artery disease: is there a link?

Gian Paolo Rossi1 / Teresa Maria Seccia2 / Achille Cesare Pessina3

1Department of Clinical and Experimental Medicine (DMCS-Internal Medicine 4), School of Medicine, University of Padua, Padua, Italy

2Department of Clinical and Experimental Medicine (DMCS-Internal Medicine 4), School of Medicine, University of Padua, Padua, Italy

3Department of Clinical and Experimental Medicine (DMCS-Internal Medicine 4), School of Medicine, University of Padua, Padua, Italy

Corresponding author: Prof. Gian Paolo Rossi, MD, FACC, FAHA, DMCS-Clinica Medica 4, University Hospital, Via Giustiniani, 2, 35126 Padova, Italy Phone: +39-049-821-3304/2279, Fax: +39-049-880-2252,

Citation Information: Clinical Chemical Laboratory Medicine. Volume 45, Issue 12, Pages 1645–1651, ISSN (Online) 14374331, ISSN (Print) 14346621, DOI: 10.1515/CCLM.2007.353, December 2007

Publication History

Received:
2007-08-16
Accepted:
2007-09-25
Published Online:
2007-12-08

Abstract

Experimental and observational studies support a role of plasma homocysteine levels (tHcy) in coronary artery disease (CAD). In the GENICA (Genetic and Environmental factors In Coronary Atherosclerosis) study, we found that high tHcy predicted cardiovascular mortality in hypertensive, but not in normotensive, patients independently of CAD and history of myocardial infarction. Moreover, despite not being associated with the coronary atherosclerotic burden, tHcy was inversely associated with left ventricular (LV) ejection fraction. This inverse relationship between LV systolic function and tHcy, which has been independently confirmed, might explain the association of tHcy with the risk of incident heart failure documented in the Framingham Heart Study. Thus, additional mechanistic investigation taking into consideration the effects of tHcy on LV function is necessary to further explore the potential therapeutic usefulness of tHcy lowering treatment in CAD.

Clin Chem Lab Med 2007;45:1645–51.

Keywords: cardiac dysfunction; coronary artery disease; homocysteine

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