PMID- 17209186
OWN - NLM
STAT- MEDLINE
DCOM- 20070215
LR  - 20230318
IS  - 0002-9165 (Print)
IS  - 0002-9165 (Linking)
VI  - 85
IP  - 1
DP  - 2007 Jan
TI  - Plasma B vitamins and their relation to the severity of chronic heart failure.
PG  - 117-23
AB  - BACKGROUND: Total homocysteine (tHcy) has been linked to the severity of chronic 
      heart failure (CHF). Elevated tHcy concentrations are mainly caused by folate and 
      vitamin B-12 deficiencies. OBJECTIVE: We hypothesized that folate and vitamin 
      B-12 deficiencies can explain the relation between tHcy and the severity of CHF. 
      DESIGN: We investigated 987 CHF patients. All subjects underwent a physical 
      examination and blood sampling. Cardiac catheterization was performed in 929 
      patients and echocardiography in 460 patients. Serum tHcy, folate, vitamin B-12, 
      and N-terminal pro-B-type natriuretic-peptide (NT-proBNP) were measured and renal 
      and hepatic function were studied. RESULTS: tHcy increased with increasing New 
      York Heart Association (NYHA) classes of heart failure (P < 0.001) and correlated 
      with the left ventricular ejection fraction (EF; r = -0.150, P < 0.001). Contrary 
      to the hypothesis, vitamin B-12 (P < 0.001) increased with NYHA class (P < 0.001) 
      and was negatively correlated with EF (r = -0.080, P = 0.015). Folate showed no 
      relation with NYHA class or EF. Comparable results were obtained for NT-proBNP 
      (tHcy: r = 0.27, P < 0.001; vitamin B-12: r = 0.091, P = 0.004; folate: r = 
      -0.045, P = 0.169). The correlations between tHcy, EF, and NT-proBNP were 
      significantly stronger in patients without coronary artery disease (CAD) than in 
      those with CAD. Regression analysis showed that tHcy, but not B vitamins, is a 
      strong predictor of EF and NT-proBNP. CONCLUSIONS: This study showed that tHcy, 
      but not folate and vitamin B-12, is related to clinical, echocardiographic, and 
      laboratory variables of CHF, which indicates a relation between tHcy and the 
      severity of CHF. This relation is stronger in patients without CAD. The lack of 
      association of folate and the paradoxical relation of vitamin B-12 with CHF can 
      possibly be explained by a disturbance in hepatic homeostasis.
FAU - Herrmann, Markus
AU  - Herrmann M
AD  - Department of Clinical Chemistry and Laboratory Medicine, University Hospital of 
      Saarland, Homburg/Saar, Germany.
FAU - Muller, Stephanie
AU  - Muller S
FAU - Kindermann, Ingrid
AU  - Kindermann I
FAU - Gunther, Laureen
AU  - Gunther L
FAU - Konig, Jochem
AU  - Konig J
FAU - Bohm, Michael
AU  - Bohm M
FAU - Herrmann, Wolfgang
AU  - Herrmann W
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am J Clin Nutr
JT  - The American journal of clinical nutrition
JID - 0376027
RN  - 0LVT1QZ0BA (Homocysteine)
RN  - 12001-76-2 (Vitamin B Complex)
RN  - 935E97BOY8 (Folic Acid)
RN  - P6YC3EG204 (Vitamin B 12)
SB  - IM
MH  - Aged
MH  - Cardiac Catheterization
MH  - Echocardiography
MH  - Female
MH  - Folic Acid/blood
MH  - Folic Acid Deficiency/*blood/complications
MH  - Heart Failure/*blood/etiology/pathology
MH  - Homocysteine/*blood
MH  - Humans
MH  - Liver/metabolism
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Severity of Illness Index
MH  - Vitamin B 12/blood
MH  - Vitamin B 12 Deficiency/*blood/complications
MH  - Vitamin B Complex/*blood
EDAT- 2007/01/09 09:00
MHDA- 2007/02/16 09:00
CRDT- 2007/01/09 09:00
PHST- 2007/01/09 09:00 [pubmed]
PHST- 2007/02/16 09:00 [medline]
PHST- 2007/01/09 09:00 [entrez]
AID - S0002-9165(23)27874-0 [pii]
AID - 10.1093/ajcn/85.1.117 [doi]
PST - ppublish
SO  - Am J Clin Nutr. 2007 Jan;85(1):117-23. doi: 10.1093/ajcn/85.1.117.