Plasma homocysteine measurements after carotid artery manipulation and clamping in a rat CEA model.

Abstract

The effect of a rat carotid endarterectomy (CEA) on homocysteine and the metabolic enzymes methylenetetrahydrofolate reductase (MTHFR) and cystathionine beta-synthase (CBS) was studied. Rats were placed into 7 groups: (1) no anesthesia (NA), (2) anesthesia only (AO), (3) skin opened and closed (O/C), (4) skin opened with exposure of the carotid artery and closed (O/E/C), (5) carotid isolated and clamped (CO), (6) open CEA, and (7) open femoral endarterectomy (FEA). End points included homocysteine, hepatic MTHFR, and CBS activity. Homocysteine in the NA, AO, O/C, O/E/C, and FEA were low and not different. CEA produced a 6-fold increase in homocysteine when compared with non-CEA groups. Specifically, CEA produced an increase in homocysteine versus the AO group at 2 weeks (11.3 +/- 0.7 vs 2.1 +/- 0.9 micromol/L;P < .001), 4 weeks (8.9 +/- 0.7 vs 3.5 +/- 0.9 micromol/L; P = .004) and 6 weeks (7.7 +/- 0.9 vs 3.1 +/- 1.5 micromol/L; P = .03). The CO group had increased homocysteine versus the O/C, O/E/C, and FEA, but was lower than the CEA group. CEA produced an increase in MTHFR and CBS versus the AO group. CEA resulted in elevated levels of homocysteine; however, when broken down into its component parts, no elevation was observed except for a small increase with the CO procedure. Manipulation of the femoral artery did not raise homocysteine levels. The increase in homocysteine is possibly due to the combination of vessel wall damage and changes in cerebral blood flow dynamics.