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Cirrhotic cardiomyopathy in children: A comprehensive assessment using ECG, echocardiography, and NT-Pro-BNP

Ataollahi Maryam1, Amir Naghshzan2, Haghighat Mahmood3

  • 1Shiraz Transplant Center, Abu-Ali Sina Hospital, Shiraz University of Medical Science, Shiraz, Iran; Gastroenterohepatology Research Center, Nemazee Teaching Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Clinics and Research in Hepatology and Gastroenterology
|October 30, 2025
PubMed

Insights

Cirrhotic cardiomyopathy (CCMP) affects over 30% of children with portal hypertension, often silently. Elevated PELD/MELD scores and ascites are key predictors, necessitating routine cardiac screening in pediatric liver disease patients.

Area of Science:

  • Pediatric Cardiology
  • Hepatology
  • Clinical Medicine

Background:

  • Cirrhotic cardiomyopathy (CCMP) is a cardiac dysfunction associated with cirrhosis.
  • Portal hypertension (PHTN) is a common complication in children with liver disease.
  • Early identification of CCMP in pediatric patients is crucial for management and prognosis.

Purpose of the Study:

  • To determine the prevalence and diagnostic criteria of CCMP in pediatric patients with PHTN.
  • To identify predictive factors for CCMP in this population.
  • To evaluate the utility of ECG, echocardiography, and NT-proBNP in diagnosing CCMP.

Main Methods:

  • A cross-sectional study involving 54 children with PHTN (45 with cirrhosis) and 54 healthy controls.
  • Participants underwent ECG, echocardiography, and NT-proBNP testing.
  • Logistic regression analysis was used to identify CCMP predictors, including PELD/MELD and Child-Pugh scores.

Main Results:

  • CCMP was present in 31.1% of cirrhotic children, with both symptomatic and silent cases.
  • Ascites and higher PELD/MELD scores were significantly associated with CCMP.
  • QTc prolongation and reduced ejection fraction were key diagnostic findings; PELD/MELD score was a significant predictor (OR 1.19, p=0.01).

Conclusions:

  • CCMP is a prevalent complication in pediatric cirrhosis with PHTN, often asymptomatic.
  • Elevated PELD/MELD scores and ascites are significant predictive factors for CCMP.
  • Routine cardiac evaluation is recommended for early detection and risk stratification in children with PHTN.
Abstract

Keywords:
CardiomyopathyLiver cirrhosisNT-proBNPPortal hypertension

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