Research Article
The relationship between Gamma-Glutamyltransferase activity and atrial fibrillation ın patients with reduced ejection fraction heart failure
Abstract
Objective: Clinically,
gamma-glutamyltransferase (GGT) activity is generally used as a diagnostic
test for liver function, biliary
tract pathologies, and alcohol consumption. GGT is the enzyme that manages the
extracellular catabolism of the main antioxidant glutathione, thus increasing
the oxidative stress or inflammatory state. Recently studies reported that GGT
is related to cardiovascular mortality and morbidity independently alcohol
consumption. Elevation of GGT in heart failure (HF), atrial fibrillation (AF),
coronary artery disease, myocardial infarction, and metabolic syndrome is
explained with inflammation and oxidative stress. Aim of this study, we have examined the relation between GGT
and AF in reduced ejection fraction heart
failure (HFrEF)
patients group.
Method: Totally one hundred and sixty-three ischemic HF patients were included in
the study retrospectively.
Electrocardiographically 63 patients have AF (40 male, 23 females, mean
age: 73±8 years) and 100
patients have normal sinus rhythm (75 male, 25 female, mean age: 71±7 years). All patients had the echocardiographic examination, ejection
fraction (EF)> 40%, severe valvular heart disease, and nonischemic HF
patients were excluded.
Results: Presence of
hypertension, age, gender, dislipidemia history, diabetes, smoking condition,
fasting glucose, and cholesterol levels were compared between two groups and
there were not statistically different (p>0.05 for all). However, serum GGT activity was increased in
patients group with AF compared to those without AF (35(10-121) U/L versus 27(6-113)U/L, p=0.01).
The optimal cut-off GGT activity for AF patients were >23,5 IU/l with a sensitivity
of 81% and a specificity of 46% (AUC =0.660, 95% CI=0.575 - 0.744)
Conclusions: In this
study, serum GGT activity was concluded to be increased in HFrEF patients with AF compared to
without AF group. More comprehensive studies
should be planned to improve the clinical use of GGT in patients with HFrEF and to investigate the
relationship between GGT and AF.
Keywords
References
- 1. Poelzl G, Eberl C, Achrainer H, Doerler J, Pachinger O, Frick M, et al. Prevalence and prognostic significance of elevated gamma-glutamyltransferase in chronic heart failure. Circ Heart Fail. 2009 Jul;2(4):294-302.
- 2. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016 Oct 7;37(38):2893-2962. doi: 10.1093/eurheartj/ehw210.
- 3. Ndrepepa G, Colleran R, Kastrati A. Gamma-glutamyl transferase and the risk of atherosclerosis and coronary heart disease. Clin Chim Acta. 2018 Jan;476:130-138. doi: 10.1016/j.cca.2017.11.026.
- 4. Lee DH, Blomhoff R, Jacobs DR Jr. Is serum gamma glutamyltransferase a marker of oxidative stress? Free Radic Res. 2004 Jun;38(6):535-9.
- 5. Lee SR, Choi EK, Han KD, Cha MJ, Oh S. Association between γ-glutamyltransferase level and incidence of atrial fibrillation: A nationwide population-based study. Int J Cardiol. 2017 Oct 15;245:149-155. doi: 10.1016/j.ijcard.2017.07.067.
- 6. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, et al, Chamber Quantification Writing Group. Recommendations for chamber quantification. Eur J Echocardiogr. 2006;7(2): 79-108.
- 7. Alonso A, Misialek JR, Amiin MA, Hoogeveen RC, Chen LY, Agarwal SK, et al. Circulating levels of liver enzymes and incidence of atrial fibrillation: the atherosclerosis risk in communities cohort. Heart. 2014 Oct;100(19):1511-6. doi: 10.1136/heartjnl-2014-305756.
- 8. Tekin G, Tekin YK, Amanvermez Senarslan D, Gocmen AY, Senarslan O, Erbay AR. Serum γ-Glutamyltransferase Activity in Patients With Nonvalvular Atrial Fibrillation. Angiology. 2013 Feb;64(2):157-60. doi: 10.1177/0003319712438956.
- 9. Lee DH, Steffen LM, Jacobs DR Jr. Association between serum gamma-glutamyltransferase and dietary factors: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Clin Nutr. 2004 Apr;79(4):600-5.
- 10. Lee DH, Jacobs DR Jr, Gross M, Steffes M. Serum gamma-glutamyltransferase was differently associated with microalbuminuria by status of hypertension or diabetes: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Clin Chem. 2005 Jul;51(7):1185-1891.
- 11. Kotani K, Shimohiro H, Adachi S, Sakane N. The association between an increased level of gamma-glutamyl transferase and systolic blood pressure in diabetic subjects. Tohoku J Exp Med. 2008 Apr;214(4):321-5.
- 12. Fraser A, Harris R, Sattar N, Ebrahim S, Smith GD, Lawlor DA. Gamma-glutamyltransferase is associated with incident vascular events independently of alcohol intake. Analysis of the British Women’s Heart and Health Study and meta-analysis. Arterioscler Thromb Vasc Biol 2007; 27: 2729–2735.
- 13. Bots ML, Salonen JT, Elwood PC, Nikitin Y, Freire de Concalves A, et al. Gamma-glutamyltransferase and risk of stroke: the EUROSTROKE project. J Epidemiol Comm Health 2002 Feb;56 Suppl 1:i25-9.
- 14. Jousilhati P, Rastenyte D, Tuomilehto J. Serum gamma-glutamyl transferase, self-reported alcohol drinking and the risk of stroke. Stroke 2000 Aug;31(8):1851-5.
- 15. S. Bulusu, M. Sharma, What does serum gamma-glutamyltransferase tell us as a cardiometabolic risk marker? Ann. Clin. Biochem. 53 (2016) 312–332.
- 16. Ozaydin M. Atrial fibrillation and inflammation. World J Cardiol. 2010 Aug 26;2(8):243-250.
- 17. Issac TT, Dokainish H, Lakkis NM. Role of inflammation in initiation and perpetuation of atrial fibrillation: a systematic review of the published data. J Am Coll Cardiol 2007; 50: 2021-2028
- 18. Wannamethee G, Ebrahim S, Shaper G. Gamma-glutamyltransferase: determinants and association with mortality from ischaemic heart disease and all causes. Am J Epidemiol 1995; 142: 699–708.
- 19. Lee DS, Evans JC, Robins SJ, Wilson PW, Albano I, Fox CS, et al. Gamma glutamyl transferase and metabolic syndrome, cardiovascular disease, and mortality risk: the Framingham heart study. Arterioscler Thromb Vasc Biol. 2007 Jan;27(1):127-33.
- 20. Ruttmann E, Brant LJ, Concin H, Diem G, Rapp K, Ulmer H; Vorarlberg Health Monitoring and Promotion Program Study Group. Gamma-glutamyltransferase as a risk factor for cardiovascular disease mortality: an epidemiological investigation in a cohort of 163,944 Austrian adults. Circulation. 2005 Oct 4;112(14):2130-2137.
- 21. Lee DH, Silventoinen K, Hu G, Jacobs DR Jr, Jousilahti P, Sundvall J, et al. Serum gamma-glutamyltransferase predicts non-fatal myocardial infarction and fatal coronary heart disease among 28,838 middle-aged men and women. Eur Heart J. 2006 Sep;27(18):2170-2176.
Year 2019,
, 328 - 334, 30.06.2019
Abstract
Supporting Institution
yok
References
- 1. Poelzl G, Eberl C, Achrainer H, Doerler J, Pachinger O, Frick M, et al. Prevalence and prognostic significance of elevated gamma-glutamyltransferase in chronic heart failure. Circ Heart Fail. 2009 Jul;2(4):294-302.
- 2. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016 Oct 7;37(38):2893-2962. doi: 10.1093/eurheartj/ehw210.
- 3. Ndrepepa G, Colleran R, Kastrati A. Gamma-glutamyl transferase and the risk of atherosclerosis and coronary heart disease. Clin Chim Acta. 2018 Jan;476:130-138. doi: 10.1016/j.cca.2017.11.026.
- 4. Lee DH, Blomhoff R, Jacobs DR Jr. Is serum gamma glutamyltransferase a marker of oxidative stress? Free Radic Res. 2004 Jun;38(6):535-9.
- 5. Lee SR, Choi EK, Han KD, Cha MJ, Oh S. Association between γ-glutamyltransferase level and incidence of atrial fibrillation: A nationwide population-based study. Int J Cardiol. 2017 Oct 15;245:149-155. doi: 10.1016/j.ijcard.2017.07.067.
- 6. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, et al, Chamber Quantification Writing Group. Recommendations for chamber quantification. Eur J Echocardiogr. 2006;7(2): 79-108.
- 7. Alonso A, Misialek JR, Amiin MA, Hoogeveen RC, Chen LY, Agarwal SK, et al. Circulating levels of liver enzymes and incidence of atrial fibrillation: the atherosclerosis risk in communities cohort. Heart. 2014 Oct;100(19):1511-6. doi: 10.1136/heartjnl-2014-305756.
- 8. Tekin G, Tekin YK, Amanvermez Senarslan D, Gocmen AY, Senarslan O, Erbay AR. Serum γ-Glutamyltransferase Activity in Patients With Nonvalvular Atrial Fibrillation. Angiology. 2013 Feb;64(2):157-60. doi: 10.1177/0003319712438956.
- 9. Lee DH, Steffen LM, Jacobs DR Jr. Association between serum gamma-glutamyltransferase and dietary factors: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Clin Nutr. 2004 Apr;79(4):600-5.
- 10. Lee DH, Jacobs DR Jr, Gross M, Steffes M. Serum gamma-glutamyltransferase was differently associated with microalbuminuria by status of hypertension or diabetes: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Clin Chem. 2005 Jul;51(7):1185-1891.
- 11. Kotani K, Shimohiro H, Adachi S, Sakane N. The association between an increased level of gamma-glutamyl transferase and systolic blood pressure in diabetic subjects. Tohoku J Exp Med. 2008 Apr;214(4):321-5.
- 12. Fraser A, Harris R, Sattar N, Ebrahim S, Smith GD, Lawlor DA. Gamma-glutamyltransferase is associated with incident vascular events independently of alcohol intake. Analysis of the British Women’s Heart and Health Study and meta-analysis. Arterioscler Thromb Vasc Biol 2007; 27: 2729–2735.
- 13. Bots ML, Salonen JT, Elwood PC, Nikitin Y, Freire de Concalves A, et al. Gamma-glutamyltransferase and risk of stroke: the EUROSTROKE project. J Epidemiol Comm Health 2002 Feb;56 Suppl 1:i25-9.
- 14. Jousilhati P, Rastenyte D, Tuomilehto J. Serum gamma-glutamyl transferase, self-reported alcohol drinking and the risk of stroke. Stroke 2000 Aug;31(8):1851-5.
- 15. S. Bulusu, M. Sharma, What does serum gamma-glutamyltransferase tell us as a cardiometabolic risk marker? Ann. Clin. Biochem. 53 (2016) 312–332.
- 16. Ozaydin M. Atrial fibrillation and inflammation. World J Cardiol. 2010 Aug 26;2(8):243-250.
- 17. Issac TT, Dokainish H, Lakkis NM. Role of inflammation in initiation and perpetuation of atrial fibrillation: a systematic review of the published data. J Am Coll Cardiol 2007; 50: 2021-2028
- 18. Wannamethee G, Ebrahim S, Shaper G. Gamma-glutamyltransferase: determinants and association with mortality from ischaemic heart disease and all causes. Am J Epidemiol 1995; 142: 699–708.
- 19. Lee DS, Evans JC, Robins SJ, Wilson PW, Albano I, Fox CS, et al. Gamma glutamyl transferase and metabolic syndrome, cardiovascular disease, and mortality risk: the Framingham heart study. Arterioscler Thromb Vasc Biol. 2007 Jan;27(1):127-33.
- 20. Ruttmann E, Brant LJ, Concin H, Diem G, Rapp K, Ulmer H; Vorarlberg Health Monitoring and Promotion Program Study Group. Gamma-glutamyltransferase as a risk factor for cardiovascular disease mortality: an epidemiological investigation in a cohort of 163,944 Austrian adults. Circulation. 2005 Oct 4;112(14):2130-2137.
- 21. Lee DH, Silventoinen K, Hu G, Jacobs DR Jr, Jousilahti P, Sundvall J, et al. Serum gamma-glutamyltransferase predicts non-fatal myocardial infarction and fatal coronary heart disease among 28,838 middle-aged men and women. Eur Heart J. 2006 Sep;27(18):2170-2176.
There are 21 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Medical Science Research Articles |
| Authors | |
| Publication Date | June 30, 2019 |
| Acceptance Date | June 24, 2019 |
| Published in Issue | Year 2019 |