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Homocysteine and P wave dispersion in patients with heart transplantation.
MedLine Citation:
PMID:  19878513     Owner:  NLM     Status:  In-Data-Review    
Acampa M, Lazzerini PE, Guideri F, Rechichi S, Capecchi PL, Maccherini M, Laghi-Pasini F. Homocysteine and P wave dispersion in patients with heart transplantation. Clin Transplant 2011: 25: 119-125. © 2009 John Wiley & Sons A/S. Abstract: Background:  Hyperhomocysteinemia (HHcy), a putative independent risk factor for the development of atherotrombosis in the general population, represents a very common finding in orthotopic heart transplantation (OHT) patients. Starting from previous studies suggesting a pro-arrhythmogenic activity of homocysteine (Hcy), we evaluated the possible correlation among Hcy plasma levels and P wave dispersion (PWD), corrected QT interval (QTc), and QTc dispersion (QTcD) as parameters of electric instability of the myocardium in patients undergone OHT whose hearts are therefore completely denervated, thus unresponsive to autonomic influences. Methods and results:  Homocysteine plasma levels, PWD, QTc, QTcD, and QTc dynamics were measured in 32 patients, who underwent OHT, and in 20 control subjects. In OHT patients, PWD (39.5 ± 11 vs. 34 ± 6 ms, p = 0.04) and QTc interval (438 ± 20 vs. 410 ± 10 ms, p < 0.001) were significantly higher in comparison with control subjects. Moreover, OHT subjects with HHcy had higher PWD values than those with normal Hcy plasma levels (44.1 ± 10.7 vs. 33.9 ± 8.8 ms, p = 0.007), but no difference was found between this latter OHT group and controls. Accordingly, in OHT patients, plasma Hcy level correlated significantly with PWD (Spearman r = 0.70; p < 0.0001), whereas no correlation was found with QTc, QTcD, and QTc circadian dynamics. Conclusion:  HHcy seems associated with an alteration in the electrical atrial conduction, possibly contributing, at least in part, to the increased risk of cardiac arrhythmias in the denervated hearts of OHT patients.
Maurizio Acampa; Pietro Enea Lazzerini; Francesca Guideri; Serena Rechichi; Pier Leopoldo Capecchi; Massimo Maccherini; Franco Laghi-Pasini
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical transplantation     Volume:  25     ISSN:  1399-0012     ISO Abbreviation:  Clin Transplant     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-02-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8710240     Medline TA:  Clin Transplant     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  119-25     Citation Subset:  IM    
Copyright Information:
© 2009 John Wiley & Sons A/S.
Division of Internal Medicine, Department of Clinical Medicine and Immunological Sciences Division of Clinical Immunology, Department of Clinical Medicine and Immunological Sciences, Department of Cardiothoracic Surgery, University of Siena, Siena, Italy.
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