Correlation of liver function and morphological abnormalities in mitral stenosis

In 50 patients with mitral stenosis in the stage of maximal clinical improvement a correlation between the functional state of liver and the morphological changes was estblished. For this purpose the serum total bilirubin concentration was determined together with the serum total protein, albumin and globulin levels, serum alanine aminotransferase, aspartate aminotransferase, cholinesterase, leucylaminopeptidase, and alkaline phosphatase activities. The bromsulphalein test, provoked hypoprothrombinemia test, and histological examination of liver biopsy specimens were made. It was found that with increasing liver morphological lesions there is a gradual but not parallel impairment of function. The most sensitive index of hepatic functional disturbances was the test of provoked hypoprothrombinemia according to Kirchmayer and Bromowiczowa. For full assessment of the degree to which the changes in the congested liver have advanced it is necessary to perform liver function tests in combination with histological examination of the organ.