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Pediatric cirrhotic cardiomyopathy: literature review and effect size estimations of selected parameters

Alexandru-Ștefan Niculae1, Simona Sorana Căinap1, Alina Grama2

  • 12nd Department of Pediatrics, Iuliu Hațieganu University of Medicine and Pharmacy, 3-5 Crișan Street, Cluj-Napoca, Romania.

European Journal of Pediatrics
|September 3, 2024
PubMed

Insights

Pediatric cirrhotic cardiomyopathy (CCM) involves structural and functional heart changes, with no specific diagnostic criteria. Further research is needed to establish tailored diagnostic tools for children with liver cirrhosis.

Area of Science:

  • Pediatric Cardiology
  • Hepatology
  • Cardiovascular Research

Background:

  • Liver cirrhosis is a global health issue impacting both adults and children.
  • Cirrhotic cardiomyopathy (CCM) is a known complication, but its pediatric manifestations and diagnostic criteria are not well-defined.
  • Existing diagnostic criteria for adult CCM are evolving and lack specificity for pediatric cases.

Purpose of the Study:

  • To review and summarize the evidence for structural and functional cardiac alterations in children with liver cirrhosis.
  • To highlight the need for tailored diagnostic criteria and assessment methods for pediatric CCM.

Main Methods:

  • Systematic review of existing literature on cardiac parameters in pediatric cirrhotic cardiomyopathy.
  • Analysis of structural abnormalities, including left ventricular mass index (LVMI) and wall thickness.
  • Evaluation of systolic and diastolic function, electrocardiographic findings, and biomarker data (BNP, troponin).

Main Results:

  • Prevalence of structural abnormalities like increased LVMI and altered ventricular wall thickness in pediatric CCM.
  • Evidence of altered systolic and diastolic function, and electrocardiographic abnormalities (e.g., prolonged QT intervals).
  • Elevated brain natriuretic peptide (BNP) levels correlate with adverse outcomes, suggesting prognostic potential.

Conclusions:

  • Pediatric CCM presents with distinct structural and functional cardiac changes.
  • These cardiac abnormalities can persist even after liver transplantation.
  • Development of tailored diagnostic criteria and comprehensive assessment strategies is crucial for effective management of pediatric CCM.

Keywords:
CardiomyopathyCholestasisCirrhosisLiver fibrosis

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