PMID- 18067448
OWN - NLM
STAT- MEDLINE
DCOM- 20080401
LR  - 20161018
IS  - 1434-6621 (Print)
IS  - 1434-6621 (Linking)
VI  - 45
IP  - 12
DP  - 2007
TI  - Homocysteine, brain natriuretic peptide and chronic heart failure: a critical 
      review.
PG  - 1633-44
AB  - Chronic heart failure (CHF) is a major public health problem causing considerable 
      morbidity and mortality. Recently, plasma homocysteine (HCY) has been suggested 
      to be significantly increased in CHF patients. This article reviews the relation 
      between hyperhomocysteinemia (HHCY) and CHF. Clinical data indicate that HHCY is 
      associated with an increased incidence, as well as severity, of CHF. In addition, 
      HCY correlates with brain natriuretic peptide (BNP), a modern biochemical marker 
      of CHF, which is used for diagnosis, treatment guidance and risk assessment. 
      Animal studies showed that experimental HHCY induces systolic and diastolic 
      dysfunction, as well as an increased BNP expression. Moreover, 
      hyperhomocysteinemic animals exhibit an adverse cardiac remodeling characterized 
      by accumulation of interstitial and perivascular collagen. In vitro superfusion 
      experiments with increasing concentrations of HCY in the superfusion medium 
      stimulated myocardial BNP release independent from myocardial wall stress. Thus, 
      clinical and experimental data underline a correlation between HHCY and BNP 
      supporting the role of HHCY as a causal factor for CHF. The mechanisms leading 
      from an elevated HCY level to reduced pump function and adverse cardiac 
      remodeling are a matter of speculation. Existing data indicate that direct 
      effects of HCY on the myocardium, as well as nitric oxide independent vascular 
      effects, are involved. Preliminary data from small intervention trials have 
      initiated the speculation that HCY lowering therapy by micronutrients may improve 
      clinical as well as laboratory markers of CHF. In conclusion, HHCY might be a 
      potential etiological factor in CHF. Future studies need to explore the 
      pathomechanisms of HHCY in CHF. Moreover, larger intervention trials are needed 
      to clarify whether modification of plasma HCY by B-vitamin supplementation 
      improves the clinical outcome in CHF patients.
FAU - Herrmann, Wolfgang
AU  - Herrmann W
AD  - Department of Clinical Chemistry and Laboratory Medicine/Central Laboratory, 
      University Hospital, Saarland University, Homburg/Saar, Germany. 
      kchwher@uniklinikum-saarland.de
FAU - Herrmann, Markus
AU  - Herrmann M
FAU - Joseph, Jacob
AU  - Joseph J
FAU - Tyagi, Suresh C
AU  - Tyagi SC
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Germany
TA  - Clin Chem Lab Med
JT  - Clinical chemistry and laboratory medicine
JID - 9806306
RN  - 0LVT1QZ0BA (Homocysteine)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Animals
MH  - Chronic Disease
MH  - Heart Failure/*etiology
MH  - Homocysteine/*blood
MH  - Humans
MH  - Natriuretic Peptide, Brain/*blood
RF  - 118
EDAT- 2007/12/11 09:00
MHDA- 2008/04/02 09:00
CRDT- 2007/12/11 09:00
PHST- 2007/12/11 09:00 [pubmed]
PHST- 2008/04/02 09:00 [medline]
PHST- 2007/12/11 09:00 [entrez]
AID - 10.1515/CCLM.2007.360 [doi]
PST - ppublish
SO  - Clin Chem Lab Med. 2007;45(12):1633-44. doi: 10.1515/CCLM.2007.360.