Are there any chinical associations with homocysteine and glycine plasma leveis in patients with atrial fibrillation?

Abstract

Introduction. Atrial fibrillation (AF) is constantly associated with a complex of various factors that create a diversity of pathophysiological variants due to phenomenon of atrial remodelling. The aim of the study was to investigate clinical associations with plasma homocysteine (Hey) and glycine (Gly) levels in patients with paroxysmal and persistent AF. Materials and methods. The study included 94 patients with ischaemic heart disease and/or hypertension without significant structural myocardial damage - 48 subjects with paroxysmal AF (group 1) and 27 subjects with persistent AF (group 2). Control group consisted of 19 patients without history of AF. Echocardiography was performed to assess left atrium (LA) size and function. Plasma levels of Hey and Gly were measured. Results. Patients with AF had significantly increased total plasma Hey level. In group 2 there was a significant correlation between Hey plasma level and LA-size. The Gly level > 349 umol/L was found to be associated with a greater AF duration and was significantly more often in patients with AF existing for more than four years. Patients with Gly plasma level > 309 umol/L and total Hey plasma > 11.02 umol/L showed significantly increased frequency of AF. Patients without AF showed Hey plasma level < 11 umol/L significantly more frequently (0% vs 29%) (p = 0.005). Conclusion. There is an association between Hey and Gly levels, atrial remodelling and the clinical course in patients with AF. It can be assumed that in a higher level of Hey, increased Gly level may serve as a predictor of more pronounced structural and functional changes in the atria, but in such case it acts as a protective mechanism.