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Investigation of cardiomyopathy in children with cirrhotic and noncirrhotic portal hypertension.
J Pediatr Gastroenterol Nutr. 2015 Feb; 60(2):177-81.JP

Abstract

BACKGROUND

Cirrhotic cardiomyopathy (CCMP) is a functional disorder characterized by electrophysiological disturbances, and diastolic and/or systolic dysfunction in patients with liver disease. This disorder is a well-defined entity in adults, but pediatric data are limited. The aim of the study was to determine the incidence, features, and risk factors of CCMP in children with portal hypertension (PHT).

METHODS

This study included 50 children with cirrhotic PHT (40/50) and noncirrhotic PHT (10/50). Fifty healthy children were also selected for the control group. Electrocardiography and echocardiography were used to evaluate cardiac functions. Corrected QT (QTc) ≥ 0.45 was accepted as prolonged on electrocardiography. The study group was divided into 3 groups: cirrhotic, noncirrhotic, and control. Then, the CCMP group was created according to the diagnostic criteria. Latent CCMP was diagnosed in the presence of prolonged-QTc along with a minor criterion (tachycardia). Manifest CCMP was diagnosed in the presence of at least 2 major criteria (prolonged-QTc along with abnormal echocardiographic findings). Moreover, in this study, the risk factors for CCMP were investigated.

RESULTS

The CCMP group included 10 cases (20%). Nine of these cases had latent CCMP (18%), and the remaining one (2%) had manifest CCMP. All of the cases with CCMP had cirrhosis and ascites. None of the patients with CCMP had severe cardiac symptoms, but they were already using some cardioprotective drugs such as propanolol and spironolactone. As risk factors for CCMP, pediatric end-stage liver disease scores, Child-Pugh scores, and ascites grades were found to be significant for the determination of CCMP. The most important risk factor was ascites severity (P = 0.001, odds ratio 9.4).

CONCLUSIONS

Approximately 20% of children with PHT have CCMP. A detailed cardiac examination should be carried out periodically in children with cirrhotic PHT, especially in the presence of ascites and high Child-Pugh score.

Authors+Show Affiliations

*Sifa Faculty of Medicine, Pediatric Gastroenterology and Hepatology, Sifa University, Izmir †Istanbul Faculty of Medicine, Pediatric Gastroenterology and Hepatology, Istanbul University, Istanbul ‡Istanbul Faculty of Medicine, Pediatric Cardiology, Istanbul University, Istanbul §Bezm-i Alem Faculty of Medicine, Pediatric Gastroenterology and Hepatology, Bezm-i Alem University, Istanbul ||Kocaeli Faculty of Medicine, Pediatric Gastroenterology and Hepatology, Kocaeli University, Izmit/Kocaeli ¶Selcuk Faculty of Medicine, Pediatric Gastroenterology and Hepatology, Selcuk University, Konya, Turkey.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25250684

Citation

Celtik, Coskun, et al. "Investigation of Cardiomyopathy in Children With Cirrhotic and Noncirrhotic Portal Hypertension." Journal of Pediatric Gastroenterology and Nutrition, vol. 60, no. 2, 2015, pp. 177-81.
Celtik C, Durmaz O, Oner N, et al. Investigation of cardiomyopathy in children with cirrhotic and noncirrhotic portal hypertension. J Pediatr Gastroenterol Nutr. 2015;60(2):177-81.
Celtik, C., Durmaz, O., Oner, N., Yavuz, T., Gökce, S., Aydogan, A., Nisli, K., Emiroglu, H. H., Ömeroglu, R. E., & Sökücü, S. (2015). Investigation of cardiomyopathy in children with cirrhotic and noncirrhotic portal hypertension. Journal of Pediatric Gastroenterology and Nutrition, 60(2), 177-81. https://doi.org/10.1097/MPG.0000000000000580
Celtik C, et al. Investigation of Cardiomyopathy in Children With Cirrhotic and Noncirrhotic Portal Hypertension. J Pediatr Gastroenterol Nutr. 2015;60(2):177-81. PubMed PMID: 25250684.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Investigation of cardiomyopathy in children with cirrhotic and noncirrhotic portal hypertension. AU - Celtik,Coskun, AU - Durmaz,Ozlem, AU - Oner,Naci, AU - Yavuz,Taner, AU - Gökce,Selim, AU - Aydogan,Aysen, AU - Nisli,Kemal, AU - Emiroglu,H Haldun, AU - Ömeroglu,Rukiye E, AU - Sökücü,Semra, PY - 2014/9/25/entrez PY - 2014/9/25/pubmed PY - 2015/11/11/medline SP - 177 EP - 81 JF - Journal of pediatric gastroenterology and nutrition JO - J Pediatr Gastroenterol Nutr VL - 60 IS - 2 N2 - BACKGROUND: Cirrhotic cardiomyopathy (CCMP) is a functional disorder characterized by electrophysiological disturbances, and diastolic and/or systolic dysfunction in patients with liver disease. This disorder is a well-defined entity in adults, but pediatric data are limited. The aim of the study was to determine the incidence, features, and risk factors of CCMP in children with portal hypertension (PHT). METHODS: This study included 50 children with cirrhotic PHT (40/50) and noncirrhotic PHT (10/50). Fifty healthy children were also selected for the control group. Electrocardiography and echocardiography were used to evaluate cardiac functions. Corrected QT (QTc) ≥ 0.45 was accepted as prolonged on electrocardiography. The study group was divided into 3 groups: cirrhotic, noncirrhotic, and control. Then, the CCMP group was created according to the diagnostic criteria. Latent CCMP was diagnosed in the presence of prolonged-QTc along with a minor criterion (tachycardia). Manifest CCMP was diagnosed in the presence of at least 2 major criteria (prolonged-QTc along with abnormal echocardiographic findings). Moreover, in this study, the risk factors for CCMP were investigated. RESULTS: The CCMP group included 10 cases (20%). Nine of these cases had latent CCMP (18%), and the remaining one (2%) had manifest CCMP. All of the cases with CCMP had cirrhosis and ascites. None of the patients with CCMP had severe cardiac symptoms, but they were already using some cardioprotective drugs such as propanolol and spironolactone. As risk factors for CCMP, pediatric end-stage liver disease scores, Child-Pugh scores, and ascites grades were found to be significant for the determination of CCMP. The most important risk factor was ascites severity (P = 0.001, odds ratio 9.4). CONCLUSIONS: Approximately 20% of children with PHT have CCMP. A detailed cardiac examination should be carried out periodically in children with cirrhotic PHT, especially in the presence of ascites and high Child-Pugh score. SN - 1536-4801 UR - https://www.unboundmedicine.com/medline/citation/25250684/Investigation_of_cardiomyopathy_in_children_with_cirrhotic_and_noncirrhotic_portal_hypertension_ L2 - https://doi.org/10.1097/MPG.0000000000000580 DB - PRIME DP - Unbound Medicine ER -