HomeCirculationVol. 113, No. 12Issue Highlights Free AccessIn BriefPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessIn BriefPDF/EPUBIssue Highlights Originally published28 Mar 2006https://doi.org/10.1161/circ.113.12.1549Circulation. 2006;113:1549RELATIONSHIP BETWEEN HOMOCYSTEINE AND MORTALITY IN CHRONIC KIDNEY DISEASE, by Menon et al.Prior studies relating plasma homocysteine to the risk of cardiovascular disease in the general population have yielded inconsistent results. Reduced glomerular filtration rate (GFR) is a risk factor for cardiovascular disease, and plasma homocysteine is related inversely to GFR. Therefore, the association of plasma homocysteine with cardiovascular disease in some earlier reports may have been confounded by inadequate adjustment for GFR. In this issue of Circulation, Menon and colleagues relate homocysteine levels to all-cause and cardiovascular mortality in patients with stages 3 to 4 chronic kidney disease enrolled in the Modification of Diet in Renal Disease Study who were followed up for a median duration of 10 years. The authors observed that plasma homocysteine levels increased with worsening GFR. In analyses adjusting for GFR (measured by the renal clearance of 125I-iothalamate), plasma homocysteine was not associated with all-cause or cardiovascular mortality. These observations suggest that plasma homocysteine may be a marker of severity of kidney disease rather than an independent risk factor in patients with stages 3 to 4 chronic kidney disease. See p 1572.IMPACT OF DIABETES MELLITUS ON REGRESSION OF ELECTROCARDIOGRAPHIC LEFT VENTRICULAR HYPERTROPHY AND THE PREDICTION OF OUTCOME DURING ANTIHYPERTENSIVE THERAPY: THE LOSARTAN INTERVENTION FOR ENDPOINT (LIFE) REDUCTION IN HYPERTENSION STUDY, by Okin et al.Research has established that left ventricular hypertrophy (LVH) is associated with excess morbidity and mortality. Moreover, recent observational and randomized data support the concept that LVH regression improves prognosis. Whether the benefits of LVH regression are equivalent across various patient subgroups is, however, uncertain. Dr Okin and colleagues examined over 9000 patients with hypertension in the Losartan Intervention For Endpoint (LIFE) Reduction in Hypertension Study, 1195 of whom had diabetes, to understand the benefits of LVH regression in patients with diabetes. Consistent with prior studies, the investigators observed that the prevalence of LVH was greater among patients with diabetes. However, with a mean follow-up of about 5 years, patients with diabetes had less electrocardiographic LVH regression. Surprisingly, though the mortality benefit of hypertension treatment in diabetes is established, LVH regression per se was not predictive of improved prognosis in those with diabetes. The data of Okin et al suggest that the pathogenesis of the poor prognosis associated with LVH in diabetes is multifactorial and merits further investigation. See p 1588.WOMEN HAVE HIGHER LEFT VENTRICULAR EJECTION FRACTIONS THAN MEN INDEPENDENT OF DIFFERENCES IN LEFT VENTRICULAR VOLUME: THE DALLAS HEART STUDY, by Chung et al.The clinical utility of ejection fraction is widely accepted, and despite the well-recognized pitfalls, it remains an important predictor of outcome in multiple different cardiac diseases. In general, common cutpoints have been applied to men and women. In this week’s journal, Chung et al acquired cardiac magnetic resonance imaging in 1435 women and 1183 men from the Dallas Heart Study. This carefully performed study in a probability-based sample of Dallas residents aged 30 to 65 demonstrated that the median left ventricular ejection fraction in women (75%) is higher than in men (70%); this is secondary to a higher stroke volume. This gender-associated difference in stroke volume is independent of end-diastolic volume and other evaluated confounders. Future work will be needed to assess the importance of this finding in the study of cardiovascular diseases. See p 1597.Visit http://circ.ahajournals.org:Clinician UpdateGastrointestinal Complications of Dual Antiplatelet Therapy. See p e655.Images in Cardiovascular MedicineSevere Left Atrial Edema and Heart Failure After Atrial Fibrillation Ablation. See p e659.Serial High-Spatial-Resolution, Multisequence Magnetic Resonance Imaging Studies Identify Fibrous Cap Rupture and Penetrating Ulcer Into Carotid Atherosclerotic Plaque. See p e660.Diffuse Infiltration of Lymphoma of the Myocardium Mimicking Clinical Hypertrophic Cardiomyopathy. See p e662. Download figureDownload PowerPointCorrespondenceSee p e665. Previous Back to top Next FiguresReferencesRelatedDetails March 28, 2006Vol 113, Issue 12 Advertisement Article InformationMetrics https://doi.org/10.1161/circ.113.12.1549 Originally publishedMarch 28, 2006 PDF download Advertisement