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

IF 2.6 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinics and research in hepatology and gastroenterology Pub Date : 2025-12-01 Epub Date: 2025-10-28 DOI:10.1016/j.clinre.2025.102721

Ataollahi Maryam , Naghshzan Amir , Haghighat Mahmood , Dehghani Mohsen , Amuzgar Hamid , Kalvandi Gholamreza , Mehdizadegan Nima , Salarian Leila

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引用次数: 0

Abstract

Objective

To evaluate the prevalence, diagnostic criteria, and predictive factors of cirrhotic cardiomyopathy (CCMP) in pediatric patients with portal hypertension (PHTN), using electrocardiography (ECG), echocardiography, and NT-proBNP levels.

Methods

This cross-sectional study included 54 children with portal hypertension (45 with cirrhosis and 9 without), and 54 age- and sex-matched healthy controls. All participants underwent ECG, echocardiography, and NT-proBNP testing. CCMP was diagnosed based on the Møller-Henriksen criteria. Demographic, clinical, and laboratory variables, including PELD/MELD and Child-Pugh scores, were analyzed. Logistic regression was used to identify predictors of CCMP.

Results

CCMP was identified in 14 cirrhotic patients (31.1 %), with 9 symptomatic and 5 silent cases. No cases were observed among non-cirrhotic patients or controls. The presence of ascites and higher PELD/MELD scores were significantly associated with CCMP. QTc prolongation and reduced ejection fraction were key diagnostic findings. Systolic dysfunction was present in 3 patients, and 4 patients with CCMP died before or shortly after liver transplantation. Multivariate analysis confirmed PELD/MELD score as a significant predictor of CCMP (OR 1.19; 95 % CI 1.038–1.367; p=0.01).

Conclusion

Cirrhotic cardiomyopathy is a prevalent but often silent complication in children with cirrhosis and PHTN. Elevated PELD/MELD scores and the presence of ascites are important predictive factors. Routine cardiac evaluation using ECG, echocardiography, and biomarkers like NT-proBNP is recommended for early detection and risk stratification in this population.

Main Points

Cirrhotic cardiomyopathy (CCMP) is an uncommon yet serious condition in children with liver disease. Current diagnostic criteria require reassessment for pediatric use, particularly considering regional genetic and environmental differences.

查看原文本刊更多论文

儿童肝硬化心肌病：使用心电图、超声心动图和NT-Pro-BNP进行综合评估。

目的：通过心电图（ECG）、超声心动图和NT-proBNP水平评估门脉高压（PHTN）患儿肝硬化心肌病（CCMP）的患病率、诊断标准和预测因素。方法：本横断面研究纳入54例门静脉高压症患儿（45例合并肝硬化，9例未合并肝硬化）和54例年龄和性别匹配的健康对照。所有参与者都进行了心电图、超声心动图和NT-proBNP测试。CCMP的诊断基于Møller-Henriksen标准。分析了人口统计学、临床和实验室变量，包括PELD/MELD和Child-Pugh评分。采用Logistic回归确定CCMP的预测因素。结果：14例肝硬化患者（31.1%）发现CCMP，其中9例有症状，5例无症状。在非肝硬化患者或对照组中未观察到病例。腹水的存在和较高的PELD/MELD评分与CCMP显著相关。QTc延长和射血分数降低是主要的诊断结果。3例患者出现收缩功能障碍，4例CCMP患者在肝移植前或移植后不久死亡。多因素分析证实PELD/MELD评分是CCMP的重要预测因子（OR 1.19; 95% CI 1.038 ~ 1.367; p=0.01）。结论：肝硬化心肌病是肝硬化和PHTN患儿的一种常见但通常不明显的并发症。PELD/MELD评分升高和腹水的存在是重要的预测因素。建议使用心电图、超声心动图和NT-proBNP等生物标志物进行常规心脏评估，以便在该人群中进行早期发现和风险分层。要点：肝硬化心肌病（CCMP）是一种罕见但严重的儿童肝脏疾病。目前的诊断标准需要重新评估儿科使用，特别是考虑到区域遗传和环境差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinics and research in hepatology and gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

4.30

自引率

3.70%

发文量

198

审稿时长

42 days

期刊介绍： Clinics and Research in Hepatology and Gastroenterology publishes high-quality original research papers in the field of hepatology and gastroenterology. The editors put the accent on rapid communication of new research and clinical developments and so called "hot topic" issues. Following a clear Editorial line, besides original articles and case reports, each issue features editorials, commentaries and reviews. The journal encourages research and discussion between all those involved in the specialty on an international level. All articles are peer reviewed by international experts, the articles in press are online and indexed in the international databases (Current Contents, Pubmed, Scopus, Science Direct). Clinics and Research in Hepatology and Gastroenterology is a subscription journal (with optional open access), which allows you to publish your research without any cost to you (unless you proactively chose the open access option). Your article will be available to all researchers around the globe whose institution has a subscription to the journal.