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European Heart Journal 2004 25(6):523-530; doi:10.1016/j.ehj.2004.01.008
Copyright © 2004 by the European Society of Cardiology.
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Clinical research

Relations of plasma homocysteine to left ventricular structure and function: the Framingham Heart Study

Johan Sundströma, Lisa Sullivand, Jacob Selhube, Emelia J Benjamina,b,c, Ralph B D'Agostinod, Paul F Jacquese, Irwin H Rosenberge, Daniel Levya,b,f, Peter W.F Wilsona and Ramachandran S Vasana,b,c,*

a The Framingham Heart Study, Framingham, MA, USA
b Department of Preventive Medicine, Boston University School of Medicine, Boston, MA, USA
c Cardiology Section, Boston University School of Medicine, Boston, MA, USA
d Department of Mathematics, Boston University, Boston, MA, USA
e The Jean Mayer–USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
f The National Heart, Lung, and Blood Institute, USA

Received August 29, 2003; revised January 3, 2004; accepted January 15, 2004 * Corresponding author. Tel.: +1-5089353450; fax: +1-5086261262
E-mail address: vasan{at}fram.nhlbi.nih.gov

Aims Hyperhomocysteinaemia is a risk factor for congestive heart failure, especially in women. We investigated if homocysteine promotes left ventricular (LV) remodelling.

Methods and results We examined cross-sectional relations of plasma total homocysteine to echocardiographic LV structure and function in 2697 Framingham Heart Study participants (mean age 58 years, 58% women) free of heart failure and previous myocardial infarction. Adjusting for age and height, plasma homocysteine was positively related to LV mass, wall thickness, and relative wall thickness in women (–0.04), but not in men (–0.68). Adjusting additionally for other clinical covariates, the relations of plasma homocysteine to LV mass and wall thickness in women remained statistically significant, but the relation to relative wall thickness became of borderline significance (1.92 g, 0.01 cm, and 0.29% increase, respectively, for a 1-SD increase in ln[homocysteine], –0.08). LV mass and wall thickness were higher in the fourth quartile of plasma homocysteine compared to the lower three in all models in women (–0.02), but not in men (–0.78). Plasma homocysteine was not related to left atrial size or LV fractional shortening in either sex.

Conclusion In our community-based sample, plasma homocysteine was directly related to LV mass and wall thickness in women but not in men.

Key Words: Heart failure • Left ventricular hypertrophy • Left ventricular remodelling • Metabolism • Echocardiography


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