vitamin-b-12 and Aortic-Diseases

Plasma homocysteine level is a risk factor for coronary events, stroke, and peripheral atherosclerotic disease. However, few data are available concerning the relationship between homocysteine level and severity of thoracic aortic atherosclerosis. We hypothesized in this multiplane transesophageal echocardiography (TEE) study that homocysteine level is a marker of the presence and severity of thoracic aortic atherosclerosis.. Cross-sectional study.. University hospital.. Risk factors, angiographic features, and TEE findings were analyzed prospectively in 82 valvular patients.. The following risk factors were recorded: age, gender, hypertension, smoking, lipid parameters, diabetes, body mass index, and family history of coronary artery disease. Plasma levels of homocysteine, vitamin B(12), and folic acid were measured for each patient. By univariate analysis, age, diabetes, hypertension, smoking, family history of coronary artery disease, and levels of homocysteine, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were significant predictors of the presence of thoracic aortic plaques. There was a positive correlation between the plasma homocysteine levels and the score of severity of thoracic atherosclerosis (r = 0.48; p = 0.0001) as well as between the homocysteine levels and the grades of severity of aortic intimal changes (p = 0.0008). Multivariate regression analysis revealed that homocysteine was an independent predictor of the presence and severity of thoracic aortic atherosclerosis.. This prospective study indicates that plasma homocysteine level is a marker of severity of thoracic atherosclerosis detected by multiplane TEE. These findings emphasize the role of homocysteine as a marker of atherosclerotic lesions in the major arterial locations.

Topics: Adult; Aged; Aged, 80 and over; Aorta, Thoracic; Aortic Diseases; Arteriosclerosis; Biomarkers; Cholesterol; Coronary Artery Disease; Cross-Sectional Studies; Echocardiography, Transesophageal; Female; Folic Acid; Homocysteine; Humans; Male; Middle Aged; Multivariate Analysis; Prospective Studies; Risk Factors; Vitamin B 12

Plasma homocyst(e)ine [H(e)] levels correlate with the prevalence of arterial occlusive diseases. Recently, transesophageal echocardiography (TEE) has been used to evaluate patients with atherosclerotic plaques in the thoracic aorta. The purpose of this study was to determine whether H(e) levels correlate with the degree of atherosclerotic plaque in the thoracic aorta (ATH) as seen on TEE. Maximum plaque areas for three locations in the thoracic aorta (arch, proximal descending, and distal descending) were measured with TEE in 156 patients. Maximum plaque areas for these locations were added to yield an estimate of ATH. ATH and H(e) levels, and levels of folic acid, vitamin B12, and pyridoxal 5'-phosphate were measured in a double-blind manner. Univariate analysis demonstrated a significant correlation of H(e) with ATH (r = 0.3, p< 0.001). On multivariate analysis, H(e) was independently predictive of ATH (r for the model including H(e) was 0.63, p < 0.0001). Plasma H(e) levels are therefore significantly and independently correlated with the degree of atherosclerosis in the thoracic aorta.

Topics: Aged; Aorta, Thoracic; Aortic Diseases; Arteriosclerosis; Echocardiography, Transesophageal; Female; Folic Acid; Homocysteine; Humans; Male; Multivariate Analysis; Observer Variation; Pyridoxal Phosphate; Pyridoxine; Risk Factors; Vitamin B 12

Topics: Adolescent; Adult; Age Factors; Aged; Aorta; Aorta, Thoracic; Aortic Diseases; Arteries; Arteriosclerosis; Biological Assay; Blood Vessels; Child; Child, Preschool; Coronary Vessels; Female; Humans; Infant; Infant, Newborn; Male; Middle Aged; Pulmonary Artery; Vena Cava, Inferior; Vitamin B 12