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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
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Authors Affiliations
  1. 1. Pediatric Gastroenterology and Hepatology Research Center, Pediatrics Centre of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Iran
  2. 2. Department of Pediatrics, School of Medicine, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

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.