Background: Homocysteine (Hcy) is involved in various methylation processes, and its
plasma level is increased in cardiac ischemia. Thus, we hypothesized that levels of
homocysteine correlate with the morphological and functional remodeling of ischemic
hearts. Thus, we aimed to measure the Hcy levels in the plasma and pericardial fluid
(PF) and correlate them with morphological and functional changes in the ischemic
hearts of humans. Methods: Concentration of total homocysteine (tHcy) and cardiac
troponin-I (cTn-I) of plasma and PF were measured in patients undergoing coronary
artery bypass graft (CABG) surgery (n = 14). Left-ventricular (LV) end-diastolic diameter
(LVED), LV end-systolic diameter (LVES), right atrial, left atrial (LA) area, thickness
of interventricular septum (IVS) and posterior wall, LV ejection fraction (LVEF),
and right ventricular outflow tract end-diastolic area (RVOT EDA) of CABG and non-cardiac
patients (NCP; n = 10) were determined by echocardiography, and LV mass was calculated
(cLVM). Results: Positive correlations were found between Hcy levels of plasma and
PF, tHcy levels and LVED, LVES and LA, and an inverse correlation was found between
tHcy levels and LVEF. cLVM, IVS, and RVOT EDA were higher in CABG with elevated tHcy
(>12 µM/L) compared to NCP. In addition, we found a higher cTn-I level in the PF compared
to the plasma of CABG patients (0.08 ± 0.02 vs. 0.01 ± 0.003 ng/mL, p < 0.001), which
was ~10 fold higher than the normal level. Conclusions: We propose that homocysteine
is an important cardiac biomarker and may have an important role in the development
of cardiac remodeling and dysfunction in chronic myocardial ischemia in humans.
