Serum Cyanocobalamin (Vitamin B12) as an Index of Hepatic Damage in Chronic Congestive Heart Failure

Abstract

It has been shown that liver-cell damage caused by various agents (viral,^1-4 chemical,⁵ infiltrating tumor ⁶) is associated with markedly increased levels of cyanocobalamin (vitamin B₁₂) in the blood, which are due to the release of the vitamin from damaged liver cells. This report deals with observations on cyanocobalamin activity in the serum of patients with severe congestive heart failure associated with hepatomegaly. Material and Methods Twenty-eight patients suffering from chronic congestive heart failure due to arteriosclerotic, rheumatic, or congenital heart disease were studied. In all patients marked hepatomegaly was present as well as venous engorgement; in some there was also ascites and peripheral edema. The duration of right heart failure preceding the time of the present examination varied from several months to seven years. Cyanocobalamin was determined mircobiologically with a mutant strain of Escherichia coli, as described previously.⁷,⁸ In some cases, repeated cyanocobalamin determinations were made before and after