| Serum alkaline phosphatase reflects post-Fontan hemodynamics in children. | |
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MedLine Citation:
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PMID: 18685798 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Alvin J Chin; P Stephens; E Goldmuntz; M B Leonard |
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Publication Detail:
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Type: Case Reports; Journal Article Date: 2008-08-07 |
Journal Detail:
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Title: Pediatric cardiology Volume: 30 ISSN: 0172-0643 ISO Abbreviation: Pediatr Cardiol Publication Date: 2009 Feb |
Date Detail:
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Created Date: 2009-02-04 Completed Date: 2009-06-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8003849 Medline TA: Pediatr Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 138-45 Citation Subset: IM |
Affiliation:
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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. chinalvi@mail.med.upenn.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Alkaline Phosphatase
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blood*,
metabolism Biological Markers / blood Bone and Bones / metabolism Cardiac Output* Child Child, Preschool Female Fontan Procedure* Heart Ventricles / abnormalities, pathology, surgery* Hemodynamics* Humans Hypoplastic Left Heart Syndrome / physiopathology, surgery* Infant Male Osteoblasts / metabolism Time Factors |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; EC 3.1.3.1/Alkaline Phosphatase |
| Comments/Corrections | |
Comment In:
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Pediatr Cardiol. 2009 Jan;30(1):91
[PMID:
19048178
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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