Gamma-Glutamyltransferase Rather Than Total Bilirubin Predicts Outcome in Chronic Heart Failure

Ess, Michael; Mussner-Seeber, Christine; Mariacher, Siegfried; Lorsbach-Koehler, Almut; Pachinger, Otmar; Frick, Matthias; Ulmer, Hanno; Poelzl, Gerhard

doi:10.1016/j.cardfail.2011.02.012

Cited by 35 publications

(32 citation statements)

References 34 publications

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“…The general results in this research are in agreement with most recent works and could favor in predicting the possibility of mortality in heart failure, cardiac and visceral disorders of elderly people [22] [23] [24] [25] [26]. An elevation of GGT activity is seen in all forms of liver disease particularly in intra-or post-hepatic bill obstruction [27].…”

Section: Discussionsupporting

confidence: 80%

Activity of the Enzyme Gamma-Glutamyl Transferase (GGT) as a Prognostic Tool for Heart Failures

Ali¹,

Bazzaz²,

Arif³

2017

ABB

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Heart failure (HF) incidence could cause further complications to other body organs, which might sometimes be fatal, and is accompanied by various biochemical alterations i.e. enzymatic changes. The objective of this study was to measure the activity of gamma glutamyl transferase (GGT) as an early diagnostic indicator for HF patients; and to isolate the iso-enzymes for the purpose of finding the Michaelis-Menten constant (Km) and the maximum velocity Vmax of each iso-enzymes which enable follow up the development of HF disease. Samples of blood sera were collected from 120 patients of both genders (70 males and 50 female, aged 30 -38 years old). Partial purification of iso-enzyme GGT was performed by precipitation, gel filtration, and ion exchange of the two iso-enzyme (I and II). The purity of the enzyme was confirmed by using Sodium dodecyl sulfate-polyacryl amide gel electrophoresis (SDS-PAGE) into two clear bands. The results were compared with other 80 samples of healthy volunteers whose ages ranged between 25 -78 years old, used as control. There has been a significant increase (p ≤ 0.01) in the activity of the enzyme GGT in the heart failure patient (66.9 ± 1.7 IU/L) in comparison with control (12.07 ± 0.60 IU/L). It is concluded that measurements of the iso-enzyme GGT could well benefit as a clear indicator criteria in prognosis of heart failure.

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Section: Discussionsupporting

confidence: 80%

Activity of the Enzyme Gamma-Glutamyl Transferase (GGT) as a Prognostic Tool for Heart Failures

Ali¹,

Bazzaz²,

Arif³

2017

ABB

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“…This study showed for the first time that high GGT activity increased mortality in HF. Ess et al [13] found that GGT activity was predictive of death and heart transplantation in stable HF. A subgroup analysis of the EVEREST study found that baseline and in-hospital changes in albumin and total bilirubin provide additional prognostic value.…”

Section: Discussionmentioning

confidence: 99%

“…A large Austrian study showed for the first time the prognostic value of GGT with regard to fatal events caused by congestive heart failure (CHF) in apparently healthy subjects [12]. Other studies have exami ned the association between HF and elevated GGT activity [13][14][15]. However, limited data exists on the prognostic value of circulating levels of GGT in patients hospitalised due to AHF.…”

Section: Introductionmentioning

confidence: 99%

Serum gamma-glutamyl transferase levels and in-hospital mortality in patients with acute heart failure

et al. 2014

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A b s t r a c tBackground: Acute heart failure (AHF) is a major cause of hospitalisation, morbidity and mortality worldwide. Gamma-glutamyl transferase (GGT) is an enzyme responsible for the extracellular catabolism of antioxidant glutathione and a potential risk indicator of cardiac mortality. Limited data exists on the prognostic value of circulating levels of GGT in patients hospitalised due to AHF. Aim:To study the association between baseline GGT activity and in-hospital mortality in AHF patients. Methods:The study cohort consisted of 183 AHF patients with left ventricular ejection fraction (LVEF) < 50%. The primary endpoint was in-hospital mortality. Patients were divided into two groups according to in-hospital mortality. The relationship between GGT activity and in-hospital mortality was tested using logistic regression models, adjusting for clinical characteristics and echocardiographic findings. Results:After adjustment for possible confounders, GGT level was significantly related (OR 1.056, 95% CI 1.018-1.096, p = 0.04) to in-hospital mortality Conclusions: Elevated GGT activity is an independent predictor of short-term mortality in patients with AHF and reduced LVEF.

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“…In a study of 1087 ambulatory HF patients, the prevalence of elevated GGT was reported to be 43% in men and 48% in women and that of total bilirubin was reported to be 17% in men and 8% in women. Both GGT and total bilirubin levels were found to be associated with disease severity, but only GGT level is independently associated with adverse outcomes in that study (45). The analysis of liver function tests in 2679 (candesartan in heart failure: assessment of reduction in mortality and morbidity) patients revealed that total bilirubin is above the upper limit of normal levels in 13% of patients.…”

Section: Clinical Findings and Implications Of The Laboratory Changesmentioning

confidence: 68%

How to interpret liver function tests in heart failure patients?

Cagli

Başar²,

Tok³

et al. 2020

Turk J Gastroenterol

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Cardiac hepatopathy has generally been used to describe any liver damage caused by cardiac disorders in the absence of other possible causes of liver damage. Although there is no consensus on the terminology used, cardiac hepatopathy can be examined as congestive hepatopathy (CH) and acute cardiogenic liver injury (ACLI). CH is caused by passive venous congestion of the liver that generally occurs in the setting of chronic cardiac conditions such as chronic HF, constrictive pericarditis, tricuspid regurgitation, or right-sided heart failure (HF) of any cause, and ACLI is most commonly associated with acute cardiocirculatory failure resulting from acute myocardial infarction, acute decompensated HF, or myocarditis. Histologically, CH is characterized by sinusoidal dilation, replacement of hepatocytes with red blood cells extravasating from the sinusoids, and necrosis/apoptosis of zone 3 of the Rappaport acinus, and it could progress to cirrhosis in advanced cases. In ACLI, however, massive necrosis of zone 3 is the main histological finding. Primary laboratory findings of CH are elevated serum cholestasis markers including bilirubin, alkaline phosphatase, and γ-glutamyl-transpeptidase levels, whereas those of ACLI are a striking elevation in transaminase and lactate dehydrogenase levels. Both CH and ACLI have a prognostic value for identifying cardiovascular events and mortality and have some special implications in the management of patients undergoing ventricular assist device implantation or cardiac transplantation. There is no specific treatment for CH or ACLI other than treatment of the underlying cardiac disorder.

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Gamma-Glutamyltransferase Rather Than Total Bilirubin Predicts Outcome in Chronic Heart Failure

Cited by 35 publications

References 34 publications

Activity of the Enzyme Gamma-Glutamyl Transferase (GGT) as a Prognostic Tool for Heart Failures

Activity of the Enzyme Gamma-Glutamyl Transferase (GGT) as a Prognostic Tool for Heart Failures

Serum gamma-glutamyl transferase levels and in-hospital mortality in patients with acute heart failure

How to interpret liver function tests in heart failure patients?

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