Study objectives: Plasma homocysteine level is a risk factor for coronary e
vents, stroke, and peripheral atherosclerotic disease. However, few data ar
e available concerning the relationship between homocysteine level and seve
rity 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.
Setting: University hospital.
Patients: Risk factors, angiographic features, and TEE findings were analyz
ed prospectively in 82 valvular patients.
Measurements and results: The following risk factors were recorded: age, ge
nder, hypertension, smoking, lipid parameters, diabetes, body mass index, a
nd family history of coronary artery disease. Plasma levels of homocysteine
, vitamin B-12, and folic acid were measured for each patient. By univariat
e analysis, age, diabetes, hypertension, smoking, family history of coronar
y artery disease, and levels of homocysteine, total cholesterol, low-densit
y lipoprotein cholesterol, and high-density lipoprotein cholesterol were si
gnificant 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 intima
l changes (p = 0.0008). Multivariate regression analysis revealed that homo
cysteine was an independent predictor of the presence and severity of thora
cic 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 athe
rosclerotic lesions in the major arterial locations.