Tom 13, Nr 6 (2016)
Niewydolność serca
Opublikowany online: 2017-04-06
Wyświetlenia strony
1215
Wyświetlenia/pobrania artykułu
3124
Znaczenie homocysteiny w niewydolności serca
Choroby Serca i Naczyń 2016;13(6):406-413.
Streszczenie
Wiele prac, zarówno doświadczalnych, jak i klinicznych, wskazuje na istotną niekorzystną rolę zwiększonego stężenia homocysteiny w surowicy krwi, które przyspiesza rozwój miażdżycy i związane z tym powikłania sercowo-naczyniowe. Ostatnio zwrócono większą uwagę na związek między hiperhomocysteinemią a niewydolnością serca (HF) również o etiologii innej niż niedokrwienna. W badaniach doświadczalnych wskazuje się, że nadmierne stężenie homocysteiny w surowicy krwi jest nie tylko markerem zaawansowania HF, związek ten odgrywa także istotną rolę w etiopatogenezie tego schorzenia. W badaniach klinicznych również podkreśla się zależność między HF, zarówno skurczową, jak i rozkurczową, a nadmiernym stężeniem homocysteiny. Wysokie stężenie homocysteiny w surowicy krwi okazało się także ważnym czynnikiem rokowniczym u chorych z przewlekłą HF. Suplementacja kwasem foliowym i witaminami z grupy B istotnie obniża stężenie homocysteiny w surowicy krwi, mimo to badania kliniczne nie dały zdecydowanej odpowiedzi, czy jednocześ-nie zmniejsza się częstość występowania powikłań sercowo-naczyniowych. Coraz liczniejsze badania prawdopodobnie dokładniej wyjaśnią rolę hiperhomocysteinemii w rozwoju HF oraz ustalą, czy i kiedy warto prowadzić terapię u chorych z tym schorzeniem.
Słowa kluczowe: niewydolność sercahomocysteinakwas foliowywitaminy B
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