Correlation between homocysteine and left ventricular myocardial fibrosis in hypertensive patients

doi:10.11958/20221111

Abstract

Abstract:

Objective To investigate the relationship between levels of homocysteine (Hcy) and left ventricular myocardial fibrosis measured by late gadolinium enhancement (CMR-LGE) in hypertensive patients. Methods Eighty-seven hypertensive patients who underwent cardiac magnetic resonance (CMR) examination were selected. According to Hcy level, patients were divided into the normal Hcy group (Hcy≤15 μmol/L, 40 cases) and the high Hcy group (Hcy>15 μmol/L, 47 cases). The clinical data of all patients were completed between the two groups. Spearman rank correlation analysis was used to analyze the correlation between Hcy and late gadolinium enhancement volume percentage (LGE%), and the correlation between Hcy and other cardiac parameters. Results The left atrial diameter (LAD), left ventricular end-diastolic diameter (LVEDD), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular mass (LVM), left ventricular mass index (LVMI) and LGE% were significantly higher in the high Hcy group than those in the normal Hcy group. The left ventricular ejection fraction (LVEF) was significantly lower in the high Hcy group than that of the normal Hcy group (P<0.05). Spearman correlation analysis showed that Hcy was positively correlated with LAD, LVEDD, LVEDV, LVESV, LVM, LVMI and LGE% (r_s were 0.356, 0.332, 0.288, 0.383, 0.338, 0.325, 0.391, respectively, all P<0.01). Hcy was negatively correlated with LVEF (r_s=-0.412, P<0.01). Conclusion Hypertensive patients with high Hcy level have severe left ventricular myocardial fibrosis, resulting in more serious left heart structure and dysfunction.

Key words: hypertension, homocysteine, ventricular dysfunction, left, endomyocardial fibrosis, early medical intervention

CLC Number:

R544.1

Figures/Tables 4

References 22

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组别		n	男性		年龄（岁）		BSA（m²）
正常Hcy组		40	24（60.0）		54.83±11.29		1.78±0.17
高Hcy组		47	34（72.3）		52.47±13.97		1.83±0.17
χ²或t			1.481		0.870		1.176
组别	BMI（kg/m²）			心率（次/min）		吸烟史		饮酒史
正常Hcy组	25.31±3.35			77.53±12.76		16（40.0）		15（37.5）
高Hcy组	25.82±4.19			83.43±16.35		28（59.6）		24（51.1）
χ²或t	0.616			1.852		3.312		1.607

组别		n	男性		年龄（岁）		BSA（m²）
正常Hcy组		40	24（60.0）		54.83±11.29		1.78±0.17
高Hcy组		47	34（72.3）		52.47±13.97		1.83±0.17
χ²或t			1.481		0.870		1.176
组别	BMI（kg/m²）			心率（次/min）		吸烟史		饮酒史
正常Hcy组	25.31±3.35			77.53±12.76		16（40.0）		15（37.5）
高Hcy组	25.82±4.19			83.43±16.35		28（59.6）		24（51.1）
χ²或t	0.616			1.852		3.312		1.607

组别	n	TC （mmol/L）	TG （mmol/L）	HDL-C （mmol/L）	LDL-C （mmol/L）	Cr （μmol/L）	UA （μmol/L）	血糖（mmol/L）	HCT
正常Hcy组	40	4.36±1.15	1.73（1.15，2.28）	1.11±0.32	2.66±0.89	79.00（67.25，98.50）	395.38±110.47	5.16（4.76，5.76）	0.43±0.05
高Hcy组	47	4.30±1.25	1.56（1.19，2.87）	1.04±0.25	2.66±0.96	97.00（85.00，132.00）	511.47±142.26	5.49（4.85，6.23）	0.45±0.06
t或Z		0.230	0.643	1.170	0.020	3.254^**	4.195^**	1.299	1.536

组别	n	TC （mmol/L）	TG （mmol/L）	HDL-C （mmol/L）	LDL-C （mmol/L）	Cr （μmol/L）	UA （μmol/L）	血糖（mmol/L）	HCT
正常Hcy组	40	4.36±1.15	1.73（1.15，2.28）	1.11±0.32	2.66±0.89	79.00（67.25，98.50）	395.38±110.47	5.16（4.76，5.76）	0.43±0.05
高Hcy组	47	4.30±1.25	1.56（1.19，2.87）	1.04±0.25	2.66±0.96	97.00（85.00，132.00）	511.47±142.26	5.49（4.85，6.23）	0.45±0.06
t或Z		0.230	0.643	1.170	0.020	3.254^**	4.195^**	1.299	1.536

组别	n		LAD（mm）	RAD（mm）		LVEDD（mm）	RVEDD（mm）		主动脉根窦部内径（mm）		LVEDV（mL）
正常Hcy组	40		33.54±6.50	40.04±6.00		51.09±8.36	38.46±6.50		27.97±3.99		131.56（111.24，163.11）
高Hcy组	47		37.71±7.22	40.75±8.01		56.63±10.02	36.30±9.29		28.73±4.07		164.09（129.64，242.02）
t或Z			2.808^**	0.476		2.770^**	1.232		0.879		2.300^*
组别		LVESV（mL）			LVEF			LVM（g）		LVMI（g/m²）		LGE%（%）
正常Hcy组		53.95（39.41，99.77）			0.58（0.40，0.64）			114.05±39.49		55.01（48.07，78.10）		0.21（0.00，3.04）
高Hcy组		100.34（61.05，166.65）			0.38（0.22，0.56）			137.12±44.97		69.77（56.36，85.77）		3.77（1.17，6.12）
t或Z		2.921^**			3.083^**			2.520^*		2.708^**		3.684^**