Elevated homocysteine is associated with reduced regional left ventricular function

The Multi-Ethnic Study of Atherosclerosis

Khurram Nasir, Michael Tsai, Boaz D. Rosen, Veronica Fernandes, David A. Bluemke, Aaron R. Folsom, Joao Lima

Research output: Contribution to journalArticle

Abstract

BACKGROUND - An elevated homocysteine (Hcy) level has been reported to be a risk factor for the development of congestive heart failure in individuals free of myocardial infarction. In this study, we aim to investigate the relationship between Hcy levels and regional left ventricular function in an asymptomatic population. METHOD AND RESULTS - Regional peak systolic midwall circumferential strains were calculated from 1178 tagged magnetic resonance imaging studies in participants in the Multi-Ethnic Study of Atherosclerosis (MESA). Left ventricular regions were defined by coronary territories (left anterior descending, left circumflex, right coronary artery). For the 1178 study participants (66±10 years of age, 58% males), the median (interquartile range) of Hcy was 9.1 (9.0 to 9.3). After adjustment for traditional risk factors, race, height, weight, left ventricular end-diastolic mass/volume, serum creatinine, and measures of atherosclerosis, reduced regional myocardial circumferential shortening across sex-specific quartiles of plasma Hcy in the left anterior descending (P=0.038) and left circumflex (P=0.009) regions persisted, which indicated an important association of reduced function with elevated Hcy. Multiple linear regression analyses confirmed that circumferential systolic dysfunction was associated with log transformed Hcy levels in the left anterior descending (P=0.004) and left circumflex (P=0.0002) regions. In the fully adjusted model, the odds ratio for left ventricular strains below the 10 percentile with 1 SD increases in log-transformed Hcy was 1.33 (95% confidence interval, 1.04 to 1.70; P=0.022) for the left anterior descending, 1.28 (95% confidence interval, 1.00 to 1.64; P=0.046) for the left circumflex, and 1.32 (95% confidence interval, 1.03 to 1.69; P=0.025) for the right coronary artery region. CONCLUSION - In this asymptomatic population, an elevated Hcy level is associated with reduced regional left ventricular systolic function detected by tagged magnetic resonance imaging.

Original languageEnglish (US)
Pages (from-to)180-187
Number of pages8
JournalCirculation
Volume115
Issue number2
DOIs
StatePublished - Jan 2007

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Homocysteine
Left Ventricular Function
Atherosclerosis
Confidence Intervals
Coronary Vessels
Magnetic Resonance Imaging
Stroke Volume
Population
Linear Models
Creatinine
Heart Failure
Odds Ratio
Myocardial Infarction
Regression Analysis
Weights and Measures
Serum

Keywords

  • Contractility
  • Heart failure
  • Homocysteine
  • Imaging
  • Magnetic resonance imaging

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Elevated homocysteine is associated with reduced regional left ventricular function : The Multi-Ethnic Study of Atherosclerosis. / Nasir, Khurram; Tsai, Michael; Rosen, Boaz D.; Fernandes, Veronica; Bluemke, David A.; Folsom, Aaron R.; Lima, Joao.

In: Circulation, Vol. 115, No. 2, 01.2007, p. 180-187.

Research output: Contribution to journalArticle

Nasir, Khurram ; Tsai, Michael ; Rosen, Boaz D. ; Fernandes, Veronica ; Bluemke, David A. ; Folsom, Aaron R. ; Lima, Joao. / Elevated homocysteine is associated with reduced regional left ventricular function : The Multi-Ethnic Study of Atherosclerosis. In: Circulation. 2007 ; Vol. 115, No. 2. pp. 180-187.
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abstract = "BACKGROUND - An elevated homocysteine (Hcy) level has been reported to be a risk factor for the development of congestive heart failure in individuals free of myocardial infarction. In this study, we aim to investigate the relationship between Hcy levels and regional left ventricular function in an asymptomatic population. METHOD AND RESULTS - Regional peak systolic midwall circumferential strains were calculated from 1178 tagged magnetic resonance imaging studies in participants in the Multi-Ethnic Study of Atherosclerosis (MESA). Left ventricular regions were defined by coronary territories (left anterior descending, left circumflex, right coronary artery). For the 1178 study participants (66±10 years of age, 58{\%} males), the median (interquartile range) of Hcy was 9.1 (9.0 to 9.3). After adjustment for traditional risk factors, race, height, weight, left ventricular end-diastolic mass/volume, serum creatinine, and measures of atherosclerosis, reduced regional myocardial circumferential shortening across sex-specific quartiles of plasma Hcy in the left anterior descending (P=0.038) and left circumflex (P=0.009) regions persisted, which indicated an important association of reduced function with elevated Hcy. Multiple linear regression analyses confirmed that circumferential systolic dysfunction was associated with log transformed Hcy levels in the left anterior descending (P=0.004) and left circumflex (P=0.0002) regions. In the fully adjusted model, the odds ratio for left ventricular strains below the 10 percentile with 1 SD increases in log-transformed Hcy was 1.33 (95{\%} confidence interval, 1.04 to 1.70; P=0.022) for the left anterior descending, 1.28 (95{\%} confidence interval, 1.00 to 1.64; P=0.046) for the left circumflex, and 1.32 (95{\%} confidence interval, 1.03 to 1.69; P=0.025) for the right coronary artery region. CONCLUSION - In this asymptomatic population, an elevated Hcy level is associated with reduced regional left ventricular systolic function detected by tagged magnetic resonance imaging.",
keywords = "Contractility, Heart failure, Homocysteine, Imaging, Magnetic resonance imaging",
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T1 - Elevated homocysteine is associated with reduced regional left ventricular function

T2 - The Multi-Ethnic Study of Atherosclerosis

AU - Nasir, Khurram

AU - Tsai, Michael

AU - Rosen, Boaz D.

AU - Fernandes, Veronica

AU - Bluemke, David A.

AU - Folsom, Aaron R.

AU - Lima, Joao

PY - 2007/1

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N2 - BACKGROUND - An elevated homocysteine (Hcy) level has been reported to be a risk factor for the development of congestive heart failure in individuals free of myocardial infarction. In this study, we aim to investigate the relationship between Hcy levels and regional left ventricular function in an asymptomatic population. METHOD AND RESULTS - Regional peak systolic midwall circumferential strains were calculated from 1178 tagged magnetic resonance imaging studies in participants in the Multi-Ethnic Study of Atherosclerosis (MESA). Left ventricular regions were defined by coronary territories (left anterior descending, left circumflex, right coronary artery). For the 1178 study participants (66±10 years of age, 58% males), the median (interquartile range) of Hcy was 9.1 (9.0 to 9.3). After adjustment for traditional risk factors, race, height, weight, left ventricular end-diastolic mass/volume, serum creatinine, and measures of atherosclerosis, reduced regional myocardial circumferential shortening across sex-specific quartiles of plasma Hcy in the left anterior descending (P=0.038) and left circumflex (P=0.009) regions persisted, which indicated an important association of reduced function with elevated Hcy. Multiple linear regression analyses confirmed that circumferential systolic dysfunction was associated with log transformed Hcy levels in the left anterior descending (P=0.004) and left circumflex (P=0.0002) regions. In the fully adjusted model, the odds ratio for left ventricular strains below the 10 percentile with 1 SD increases in log-transformed Hcy was 1.33 (95% confidence interval, 1.04 to 1.70; P=0.022) for the left anterior descending, 1.28 (95% confidence interval, 1.00 to 1.64; P=0.046) for the left circumflex, and 1.32 (95% confidence interval, 1.03 to 1.69; P=0.025) for the right coronary artery region. CONCLUSION - In this asymptomatic population, an elevated Hcy level is associated with reduced regional left ventricular systolic function detected by tagged magnetic resonance imaging.

AB - BACKGROUND - An elevated homocysteine (Hcy) level has been reported to be a risk factor for the development of congestive heart failure in individuals free of myocardial infarction. In this study, we aim to investigate the relationship between Hcy levels and regional left ventricular function in an asymptomatic population. METHOD AND RESULTS - Regional peak systolic midwall circumferential strains were calculated from 1178 tagged magnetic resonance imaging studies in participants in the Multi-Ethnic Study of Atherosclerosis (MESA). Left ventricular regions were defined by coronary territories (left anterior descending, left circumflex, right coronary artery). For the 1178 study participants (66±10 years of age, 58% males), the median (interquartile range) of Hcy was 9.1 (9.0 to 9.3). After adjustment for traditional risk factors, race, height, weight, left ventricular end-diastolic mass/volume, serum creatinine, and measures of atherosclerosis, reduced regional myocardial circumferential shortening across sex-specific quartiles of plasma Hcy in the left anterior descending (P=0.038) and left circumflex (P=0.009) regions persisted, which indicated an important association of reduced function with elevated Hcy. Multiple linear regression analyses confirmed that circumferential systolic dysfunction was associated with log transformed Hcy levels in the left anterior descending (P=0.004) and left circumflex (P=0.0002) regions. In the fully adjusted model, the odds ratio for left ventricular strains below the 10 percentile with 1 SD increases in log-transformed Hcy was 1.33 (95% confidence interval, 1.04 to 1.70; P=0.022) for the left anterior descending, 1.28 (95% confidence interval, 1.00 to 1.64; P=0.046) for the left circumflex, and 1.32 (95% confidence interval, 1.03 to 1.69; P=0.025) for the right coronary artery region. CONCLUSION - In this asymptomatic population, an elevated Hcy level is associated with reduced regional left ventricular systolic function detected by tagged magnetic resonance imaging.

KW - Contractility

KW - Heart failure

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KW - Imaging

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