Document Detail

Serum alkaline phosphatase reflects post-Fontan hemodynamics in children.
MedLine Citation:
PMID:  18685798     Owner:  NLM     Status:  MEDLINE    
Although survivors of Fontan palliation for a single ventricle are known to have lower cardiac index than patients with two-ventricle surgical reconstructions, it is unclear whether two frequently observed sequelae, short stature and protein-losing enteropathy (PLE), have hemodynamic origins. A serum marker that reflects hemodynamic status would be a tremendous asset in the long-term management of children with these sequelae. The authors recently noted severely reduced total alkaline phosphatase (TALP) levels in two children with early-onset PLE after Fontan operations, both of whom had low cardiac output at cardiac catheterization. Catheter-based or surgical interventions that rapidly increased cardiac output in these two patients resulted not only in relief of PLE but also in a prompt TALP rise. To examine whether the apparent correlation of low TALP with impaired cardiac output also is seen in Fontan patients without PLE, this study retrospectively examined the TALP data from two other Fontan patients who underwent cardiac catheterization specifically to assess the potential benefit of vasodilator therapy. The TALP levels were abnormally low in both cases but increased after up-titration of angiotensin-converting enzyme inhibition. Serum TALP activity, an indicator of osteoblastic function particularly in pre-adolescence, may be a marker of low cardiac output after a Fontan operation.
Alvin J Chin; P Stephens; E Goldmuntz; M B Leonard
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2008-08-07
Journal Detail:
Title:  Pediatric cardiology     Volume:  30     ISSN:  0172-0643     ISO Abbreviation:  Pediatr Cardiol     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-04     Completed Date:  2009-06-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003849     Medline TA:  Pediatr Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  138-45     Citation Subset:  IM    
Division of Cardiology, Abramson Research Center, The Children's Hospital of Philadelphia, and Department of Pediatrics, University of Pennsylvania, School of Medicine, Philadelphia, PA 19104, USA.
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MeSH Terms
Alkaline Phosphatase / blood*,  metabolism
Biological Markers / blood
Bone and Bones / metabolism
Cardiac Output*
Child, Preschool
Fontan Procedure*
Heart Ventricles / abnormalities,  pathology,  surgery*
Hypoplastic Left Heart Syndrome / physiopathology,  surgery*
Osteoblasts / metabolism
Time Factors
Reg. No./Substance:
0/Biological Markers; EC Phosphatase
Comment In:
Pediatr Cardiol. 2009 Jan;30(1):91   [PMID:  19048178 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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