Methylenetetrahydrofolate Reductase (MTHFR) Polymorphism in Korean Chronic Renal Failure Patients: Impacts on Hyperhomocysteinemia and Peripheral Atherosclerosis / 대한신장학회지

PURPOSE: Recently, many studies have investigated that Methylenetetrahydrofolate Reductase (MTHFR) polymorphism may be not a only cause for hyperhomocysteinemia, but also an independent risk factor for cardiovascular disease or atherosclerosis in renal failure patients. In this study, we analyzed MTHFR polymorphisms in chronic renal failure (CRF) patients, and investigated relationship between MTHFR polymorphism and peripheral atherosclerosis. METHODS: One hundred twenty eight CRF patients with GFR < 30 mL/min were enrolled. We analyzed their MTHFR polymorphism by standard PCR/restriction fragment length polymorphism and measured their ankle brachial index (ABI) using blood pressure cuff and Doppler stethoscope. Plasma homocysteine, vitamin B12, and folic acid levels were measured. 170 healthy peoples were enrolled for control group. RESULTS: The distribution of MTHFR 677 polymorphism of CRF patients was as follows: CC genotype, 33.6%; CT, 47.7% and TT 18.7%. Plasma homocysteine concentration was higher in TT group than in CC group (p < 0.05). The distribution of MTHFR 1298 polymorphism of CRF patients was as follows: AA type, 63.78%; AC, 33.07% and CC 18.7%. The distributions of MTHFR polymorphisms in control group were not different from patients group, respectively. There was no definite correlation between ABI and plasma homocysteine concentration. A trend of lower ABI in TT type compared with CC type within CRP patients group, but no statistical significance was shown. CONCLUSIONs: No difference of the distribution of MTHFR polymorphism was noted between CRF patients and healthy population. In CRF patients, MTHFR C677T mutation was closely associated with hyperhomocysteinemia, but both did not significantly influence to peripheral arterial disease.

CT Coronary Angiography Using Multidetector Computed Tomography in Coronary Artery Disease : A Comparative Study to Quantitative Coronary Angiography

BACKGROUND AND OBJECTIVES: The purpose of the present study was to investigate the diagnostic accuracy of coronary stenoses in patients with ischemic heart disease using multidetector CT coronary angiography (MDCT) in the assessment of coronary artery disease. SUBJECTS AND METHODS: Forty-three patients (49-72yrs) undergoing conventional coronary angiography (CCA) were included in this study. All patients were premedicated with oral propranolol, 40-80 mg, to achieve an acceptable heart rate of less than 65 bpm, 1hr before the MDCT. All coronary arteries, including the distal segments and side branches, were assessed with respect to assessability and the presence of significant stenosis (>50%) and the results compared with those of CCA. RESULTS: Of the 645 coronary artery segments scanned, 540 were assessable (84%). A total 44 significant stenoses were detected by CCA and 49 lesions by MDCT. The overall sensitivity and specificity were 77 and 97%, respectively. The overall accuracy for the LAD, RCA and LCX was 94, 98 and 95%, respectively, and there were no differences in the accuracies in each vessel. The sensitivity in the proximal segments was much higher than in the distal segments. A total 15 segments were overestimated by the MDCT due to calcification and the small vessel size. CONCLUSION: MDCT, with improved spatial and temporal resolutions, and pre-treated with oral beta-blocker, permits the detection of coronary artery stenoses with a high degree of accuracy.