Increased plasma homocysteine predicts arrhythmia recurrence after minimally invasive epicardial ablation for nonvalvular atrial fibrillation

Nasso, Giuseppe; Bonifazi, Raffaele; Romano, Vito; Brigiani, Mario Siro; Fiore, Flavio; Bartolomucci, Francesco; Lamarra, Mauro; Fattouch, Khalil; Rosano, Giuseppe; Gaudino, Mario; Spirito, Roberta; Gaudio, Carlo; Saglio, Giuseppe

doi:10.1016/j.jtcvs.2012.07.099

Cited by 18 publications

(14 citation statements)

References 24 publications

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“…Crosssectional clinical studies indicated that AF patients had elevated homocysteine levels (16,17) and decreased vitamin B6 levels compared with controls (16), whereas a prospective epidemiological study showed no significant association of AF with homocysteine (18). Several observational clinical studies have reported the positive association of homocysteine with recurrent AF risk after ablation (19)(20)(21). Given the close relation of homocysteine with atherosclerotic CVD and AF recurrence, homocysteine may be associated with incident AF in the general population.…”

Section: Introductionmentioning

confidence: 99%

Homocysteine and Incident Atrial Fibrillation: The Atherosclerosis Risk in Communities Study and the Multi-Ethnic Study of Atherosclerosis

Kubota

Alonso

Heckbert

et al. 2019

Heart, Lung and Circulation

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Section: Introductionmentioning

confidence: 99%

Homocysteine and Incident Atrial Fibrillation: The Atherosclerosis Risk in Communities Study and the Multi-Ethnic Study of Atherosclerosis

Kubota

Alonso

Heckbert

et al. 2019

Heart, Lung and Circulation

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“…Depending on the above-described criteria of evaluation, 11 validated articles were included for analysis in our study. [5][6][7][10][11][12][13][14][15][16][17] The main characteristics of the included studies are shown in the Table. Comparisons of homocysteine levels between AF patients and control subjects: Four studies were included in the comparisons of homocysteine levels between AF patients and control subjects. The random-effects model was used since heterogeneity existed (I 2 = 92.7%, P = 0.000).…”

Section: Resultsmentioning

confidence: 99%

Elevated Homocysteine Levels Associated with Atrial Fibrillation and Recurrent Atrial Fibrillation

Rong¹,

Huang²,

Jin³

et al. 2020

Int. Heart J.

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There is increasing evidence linking plasma homocysteine levels and atrial fibrillation (AF). The association between an elevated level of plasma homocysteine and AF was examined by meta-analysis in this study. The PubMed and ScienceDirect databases until August 2019 were utilized to collect previous literature on homocysteine and the potential relation to AF. The pooled effects were evaluated depending on standardized mean differences (SMDs) or odds ratios (ORs) with 95% confidence intervals (CIs), and the calculation was performed using Stata 12 software. A total of 11 validated articles were included in the meta-analysis. For pooled effect, the results confirmed that AF patients had higher homocysteine levels than control subjects (SMD: 0.58, 95%CI: 0.09-1.06). Compared with control subjects, homocysteine levels were higher in paroxysmal AF (SMD: 0.45, 95%CI: 0.18-0.72) and persistent AF patients (SMD: 1.21, 95%CI: 0.50-1.92). The pooled analysis suggested that patients with elevated homocysteine levels had markedly higher risk of AF compared with lower homocysteine levels in the categorical variable (OR: 2.21, 95%CI: 1.16-4.21) and continuous variable analyses (OR: 1.13, 95%CI: 1.00-1.27), respectively. In addition, the pooled analysis indicated that recurrent AF patients had significantly higher homocysteine levels than those without recurrence (SMD: 0.65, 95%CI: 0.42-0.88). The pooled analysis of the categorical variables indicated that elevated homocysteine levels were associated with increased risk of AF recurrence (OR: 3.81, 95%CI: 3.11-4.68). However, the association was weak in the pooled analysis of continuous variables (OR: 1.88, 95%CI: 0.74-4.81). Our meta-analysis identified that plasma homocysteine levels were significantly elevated in AF and recurrent AF patients. Elevated homocysteine is associated with increased risk of AF and AF recurrence.

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“…In a large prospective study, Cai et al [27] found that high Hcy level is a risk factor for the occurrence of atrial fibrillation, potentially due to the fact that long-term high Hcy levels can interfere with the potassium channel currents of atrial myocytes and cause electrical remodeling of the atrium. Nasso et al [28] found that Hcy levels in peripheral blood are an independent predictor of recurrence in patients with atrial fibrillation (including paroxysmal and persistent atrial fibrillation) after epicardial ablation. However, the model that oxidative stress mediates the pathological consequences associated with elevated homocysteine remains controversial [29].…”

Section: Discussionmentioning

confidence: 99%

Correlation between serum homocysteine, Galectin-3 concentration and atrial structural remodeling in atrial fibrillation patients

Sun

Liang

et al. 2020

Pteridines

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Objective To investigate the correlation between serum homocysteine (Hcy), Galectin-3 concentration and atrial structural remodeling in atrial fibrillation (AF) patients.Methods Twenty-five patients with persistent atrial fibrillation (PeAF), 24 patients with paroxysmal atrial fibrillation (PaAF) and 23 healthy controls were included in the present work. All subjects received an echocardiography examination. Serum concentration of Hcy and Galectin-3 were also examined by Enzyme Linked Immunosorbent Assay (ELISA).Results Echocardiography examination demonstrated that there were significant differences for LAD (p=0.002), LVEF (p=0.005) and LVAI (p=0.0001) between the control, PaAF and PeAF groups. However, LVSD and LVDD were not significantly different between the three groups (pall>0.05). There was a significant positive correlation between LAVI and serum Hcy level in both PaAF (rpearson=0.49, p=0.016) and PeAF (rpearson=0.51, p=0.009) groups. The correlation between LAVI and serum Galectin-3 concentration was also statistically significant for PaAF (rpearson=0.54, p=0.006) and PeAF (rpearson=0.60, p=0.001) groups. Using serum Hcy as reference, diagnostic sensitivity and specificity were calculated as 72.00 (95%CI: 50.61-87.93) and 62.50 (95%CI: 40.59-81.20), respectively, with an AUC of 0.68 for PaAF and PeAF. For serum Galectin-3, the sensitivity and specificity values were 64.00 (95%CI:42.52-82.03) and 66.67 (95%CI:44.68-84.37), respectively, with an AUC of 0.68.Conclusion: Serum Hcy and Galectin-3 were elevated in AF patients and thus may be potential markers of atrial structural remodeling. However, the diagnostic efficacy of PeAF from PaAF was limited by low AUC values.

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Increased plasma homocysteine predicts arrhythmia recurrence after minimally invasive epicardial ablation for nonvalvular atrial fibrillation

Abstract: The homocysteine level measured during the follow-up reliably predicts the risk of recurrence after epicardial ablation of nonvalvular atrial fibrillation via minithoracotomy. Specific treatments to reduce plasma homocysteine could be considered in the future in these patients.

Cited by 18 publications

References 24 publications

Homocysteine and Incident Atrial Fibrillation: The Atherosclerosis Risk in Communities Study and the Multi-Ethnic Study of Atherosclerosis

Homocysteine and Incident Atrial Fibrillation: The Atherosclerosis Risk in Communities Study and the Multi-Ethnic Study of Atherosclerosis

Elevated Homocysteine Levels Associated with Atrial Fibrillation and Recurrent Atrial Fibrillation

Correlation between serum homocysteine, Galectin-3 concentration and atrial structural remodeling in atrial fibrillation patients

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