Study objectives: 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.
Design: Cross-sectional study.
Patients: Risk factors,
angiographic features, and TEE findings were analyzed prospectively in
82 valvular patients.
Measurements and results: 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 B12, 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.
Conclusion: 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