Copyright © 1994 by the European Society of Cardiology.
© 1994 The European Society of Cardiology
Hyperhomocysteinaemia in heart transplant recipients
Departments of Cardiology, Biochemistry and Thoracic Surgery, Hôpital de la Timone Marseille, France
Received 23 February 1993; revised 12 April 1994; .
Correspondence P. Ambrosi, Service de Cardiologie B, H
pital de la Timone, Boulevard Jean Moulin, 13005, Marseille, France.
Abstract
The aim of this study was to determine the prevalence of hyperhomocysteinaemia in cardiac transplant recipients, Three groups of subjects were studied: 27 heart transplant recipients, 14 to 63 months (mean=36.5) after transplantation; 10 patients with moderate chronic renal insufficiency without clinical evidence of vascular disease; 17 apparently healthy individuals. Twenty-five out of 27 transplanted patients had a coronaroangiography within 6 months of homocysteine measurement. Plasma homocysteine was measured both while the subject was fasting (tO) and 6 h after administration of 0.1 g. kg–1 of methionine (t6). Hyperhomocysteinaemia was present in 14127 fasting transplanted patients and after methionine loading. Mean plasma levels of homocysteine at tO were higher (P=0.03) in transplanted heart recipients (15.4 ± 7µmol. l–1 than in the renal patients (9.9±5µmol. l–1) despite similar mean plasma creatinin. In eight transplanted patients with angiographic coronary abnormalities of the cardiac graft, homocysteinaemia was at tO 17.1 ±9 µmol. l–1 and at t6 47.8 ±25 µmol. l–1. In 17 transplanted patients with angiographically normal coronary arteries, plasma homocysteine levels were at tO, 13.2 ±4µmol. l–1 and at t6, 46.8±25µmol. l–1.
We conclude that hyperhomocysteinaemia is common in transplanted heart recipients, and partly related to renal insufficiency. No correlation was found between hyperhomocysteinaemia and angiographic evidence of coronary atherosclerosis of the graft, but the population of the study was possibly too small to establish this correlation.
Key Words: Homocysteine • heart transplantation • coronary atherosclerosis
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