Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2020 , Vol 11, Issue 2
Is Gamma-Glutamyl Transferase Elevation Associated With Cardiac Failure In Infants With Ventricular Septal Defect?
Fatih Aygün1,Ahmet İrdem2
1İstanbul Üniversitesi-Cerrahpaşa, Çocuk Sağlığı ve Hastalıkları, Çocuk Yoğun Bakım, İstanbul, Türkiye
2SBÜ. Okmeydanı Eğitim ve Araştırma Hastanesi, Çocuk Sağlığı ve Hastalıkları, Çocuk Kardiyolojisi, İstanbul, Türkiye
DOI : 10.31067/0.2020.267 Purpose/Aim: Ventricular septal defect (VSD) which is the most common cause of congenital heart defects in children, can lead to heart failure 6?8 weeks after birth due to the decrease in the pulmonary vascular resistance. The clinical features of cardiac failure can be subtle during the infant period, so the laboratory parameters can help the diagnosis and the follow-up. The relation between gamma-glutamyl transferase (GGT) and cardiac failure is reported in adults. Herein, we aimed to evaluate the relationship between liver enzymes especially GGT levels and cardiac failure developing due to VSD in pediatric patients.

Patients and Methods: The medical records of patients age between 1 month and 1 year old were analysed retrospectively. The patients were admitted in the pediatric intensive care unit (PICU) with clinical manifestations of cardiac failure and patients with VSD having a certain cardiac failure were evaluated. The liver enzyme levels were compared among patients having cardiac failure or not.

Results: Ventricular septal defect and cardiac failure were determined in 25 patients totally. The mean age of the patients was 6.83±3.71 months. Fifteen patients (60.0%) used to have mechanical ventilation support and the mean duration of hospitalization in the intensive care unit was 15.32±13.85 days. As the patients were separated in two groups having cardiac failure and not, there was statistically a relation between alanine aminotransferase (ALT) (p<0.001), aspartate aminotransferase (AST) (p<0.001), gamma-glutamyl transferase (GGT) (p=0.013) and lactate dehydrogenase (LDH) (p=0.026) levels. Analysis of ROC curves was demonstrated as 0.849, 0.792, 0.660 and 0.785 respectively for ALT, AST, LDH and GGT.

Conclusion: The increased liver enzyme levels can be an early marker of cardiac failure in infants with VSD. Keywords : Pediatric intensive care, cardiac failure, liver, ventricular septal defect