Homocysteine and P wave dispersion in patients with heart transplantation
Article first published online: 30 OCT 2009
© 2009 John Wiley & Sons A/S
Volume 25, Issue 1, pages 119–125, January/February 2011
How to Cite
Acampa, M., Lazzerini, P. E., Guideri, F., Rechichi, S., Capecchi, P. L., Maccherini, M. and Laghi-Pasini, F. (2011), Homocysteine and P wave dispersion in patients with heart transplantation. Clinical Transplantation, 25: 119–125. doi: 10.1111/j.1399-0012.2009.01126.x
- Issue published online: 30 OCT 2009
- Article first published online: 30 OCT 2009
- Accepted for publication 22 May 2009
- cardiac arrhythmias;
- orthotopic heart transplantation;
- P wave dispersion;
- QT interval
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.