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Investigating Cardiopulmonary Complications in Cirrhotic Pediatrics With Contrast Echocardiography Publisher



Rohani P1 ; Motamedi E1 ; Kariman A1 ; Vahidshahi K2 ; Fathi Khorasani M1 ; Sohouli MH1
Authors

Source: Progress in Pediatric Cardiology Published:2025


Abstract

Background: Liver cirrhosis is a rare but serious form of liver dysfunction that can lead to severe complications including cardiopulmonary involvement in children. Objectives: In this study, our aim is to investigate the cardiopulmonary complications in children with cirrhosis by using contrast echocardiography. Method: In this observational cross-sectional study, all pediatrics diagnosed with cirrhosis were enrolled from 2020 to 2024. Demographic data, weight, height, BMI, z-score, consanguinity, patient's history, cause of cirrhosis, family history of cirrhosis, laboratory data, abdominal sonography, liver biopsies, and saline contrast echocardiography for arteriovenous malformation (AVM) were evaluated and recorded. Result: A total of twenty-two children were observed, with 59 % of them being boys. The average age of all the children was 8.43 ± 4.6 years. During the study, it was found that 27.3 % of the patients had mild left ventricular diastolic dysfunction, 13.6 % had mild AVM, and 4.5 % had moderate AVM in the contrast echocardiography. No relationship was found between cardiopulmonary complications with age, sex, and laboratory data. However, there was a significant relationship between moderate AVM diagnosed in contrast echocardiography and nodular formation, as well as a significant relationship between left ventricular enlargement (LVE) and nodular formation. One patient had nodular formation in the liver biopsy concurrent with LVE and moderate AVM. Mild AVM was seen in a patient with severe vascular change and giant cell transformation. Additionally, there was a relationship between contrast echocardiography and BUN, creatinine, and vitamin D levels (all P-values <0.05). Conclusion: The results of contrast echocardiography are correlated with some complications of cirrhosis and can be used as a method to evaluate cardiopulmonary complications in children with cirrhosis. © 2025 Elsevier B.V.