All issues > Volume 31(1); 1988

Original Article

J Korean Pediatr Soc. 1988;31(1):48-57. Published online January 31, 1988.

Liver Function Test in Congestive Heart Failure in Children.

Chan Yung Kim¹, Man Chul Ha¹

¹Department of Pediatrics, College of Medicine, Pusan National University, Pusan, Korea

Received: October 30, 1987;

Abstract

Clinical study was carried out on 149 congestive heart failure(CHF) cases of 873 heart disease patients admitted to the Department of Pediatics, Pusan National University Hospital from January 1980 to June 1987 and performed various diagnostic evaluations, especially liver function tests. The results obtained were as follows. 1) The congenital (CHD) and acquired (AHD) cause of heart disease were each 75.9% and 19.0% and the rest, the other origin 5.1%. The congenital origin of CHF was seen in all ages, whereas the acquired origin was seen mainly in school age. The average incidence of CHD in CHF was 15.4%. Also, there significant increase in the incidence to CHF in infancy (21.9%) compaired to late school age (7.2%). The average incidence of CHF in AHD was 22.3%. 2) The most common precipitating factors of CHF was infection, such as URI (32.2%) and pneumo- nia (21.5%). The others including discontinuation of digitalis, delayed visit to hospital and physical exertion also precipitate CHF. The most common symptom of CHF was dyspnea (74.4%), and others were engorgement of cervical vein, hepatomegaly, and pulmonary rale. 3) The average incidence of CHF was 6% in each of ASD and TOF which is relatively minimal and tend to occur in early childhood and school age, whereas 11% and 19% in each of PDA and VSD respectively which is relatively higher and tend to occur in infancy. The most common cause of CHF in AHD was rheumatic carditis. The incidence to CHF was lower in mitral insufficiency, whereas higher in congestive cardiomyopathy and bacterial endocarditis. 4) On the aspect of the liver function tests in the children with CHF, SGOT and SGPT above 200 IU were 27.4%, 23.2%, respectively and those above 200 IU were each of 3,4 cases. The proportion of elevated direct bilirubin level (1.0 mg% or more) was 23.0% and that of elevated indirect bilirubin level (1.5 mg% or more) was 24.4%, and that of elevated total bilirubin level (2.0 mg% or more) was 27.4% of cases. The children presenting hypoalbuminemia (3.0 gm% or less) were 31.3% and the children whose globulin level were above 3.0 gm%, were 3.7%. The reverse of A/G ratio was seen in 31.8% of cases.

Keywords :Congestive Heart Failure, Liver Function Test