{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:19:43Z","timestamp":1791893983617,"version":"4.3.4"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2019,2,17]],"date-time":"2019-02-17T00:00:00Z","timestamp":1550361600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2019,2,17]],"date-time":"2019-02-17T00:00:00Z","timestamp":1550361600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:p>\n                    Cirrhotic cardiomyopathy (CCM), a comorbidity of end\u2010stage cirrhotic liver disease, remains uncharacterized in children, largely because of a lack of an established pediatric definition. The aim of this retrospective cohort analysis is to derive objective two\u2010dimensional echocardiographic (2DE) criteria to define CCM associated with biliary atresia (BA), or BA\u2010CCM, and correlate presence of BA\u2010CCM with liver transplant (LT) outcomes in this population. Using receiver operating characteristic (ROC) curve analysis, optimal cut\u2010off values for left ventricular (LV) geometrical parameters that were highly sensitive and specific for the primary outcomes: A composite of serious adverse events (CSAE) and peritransplant death were determined. These results were used to propose a working definition for BA\u2010CCM: (1) LV mass index (LVMI) \u226595 g\/m\n                    <jats:sup>2.7<\/jats:sup>\n                    or (2) relative wall thickness of LV \u22650.42. Applying these criteria, BA\u2010CCM was found in 34 of 69 (49%) patients with BA listed for LT and was associated with increased multiorgan dysfunction, mechanical and vasopressor support, and longer intensive care unit (ICU) and hospital stays. BA\u2010CCM was present in all 4 waitlist deaths, 7 posttransplant deaths, and 20 patients with a CSAE (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.01). On multivariable regression analysis, BA\u2010CCM remained independently associated with both death and a CSAE (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.01). Utilizing ROC analysis, LVMI was found to be a stronger predictor for adverse outcomes compared with current well\u2010established markers, including Pediatric End\u2010Stage Liver Disease (PELD) score.\n                    <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic>\n                    BA\u2010CCM is highly sensitive and specific for morbidity and mortality in children with BA listed for LT. 2DE screening for BA\u2010CCM may provide pertinent clinical information for prioritization and optimal peritransplant management of these children.\n                  <\/jats:p>","DOI":"10.1002\/hep.30204","type":"journal-article","created":{"date-parts":[[2018,8,7]],"date-time":"2018-08-07T02:29:30Z","timestamp":1533608970000},"page":"1206-1218","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":39,"title":["Clinical Consequences of Cardiomyopathy in Children With Biliary Atresia Requiring Liver Transplantation"],"prefix":"10.1097","volume":"69","author":[{"given":"Noelle M.","family":"Gorgis","sequence":"first","affiliation":[{"name":"Section of Pediatric Critical Care,Baylor College of Medicine,Houston,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Curtis","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Section of Pediatric Critical Care,Baylor College of Medicine,Houston,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2034-2625","authenticated-orcid":false,"given":"Fong","family":"Lam","sequence":"additional","affiliation":[{"name":"Section of Pediatric Critical Care,Baylor College of Medicine,Houston,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Thompson","sequence":"additional","affiliation":[{"name":"Section of Pediatric Critical Care,Baylor College of Medicine,Houston,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Coss\u2010Bu","sequence":"additional","affiliation":[{"name":"Section of Pediatric Critical Care,Baylor College of Medicine,Houston,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayse","family":"Akcan Arikan","sequence":"additional","affiliation":[{"name":"Section of Pediatric Critical Care,Baylor College of Medicine,Houston,TX"},{"name":"Section of Pediatric Nephrology,Baylor College of Medicine,Houston,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trung","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Section of Pediatric Critical Care,Baylor College of Medicine,Houston,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Hosek","sequence":"additional","affiliation":[{"name":"Section of Pediatric Gastroenterology and Hepatology,Baylor College of Medicine,Houston,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamir","family":"Miloh","sequence":"additional","affiliation":[{"name":"Section of Pediatric Gastroenterology and Hepatology,Baylor College of Medicine,Houston,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saul J.","family":"Karpen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics,Emory University School of Medicine,Atlanta,GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Penny","sequence":"additional","affiliation":[{"name":"Section of Pediatric Cardiology,Baylor College of Medicine,Houston,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Goss","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Abdominal Transplantation and Hepatobiliary Surgery,Baylor College of Medicine,Houston,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moreshwar S.","family":"Desai","sequence":"additional","affiliation":[{"name":"Section of Pediatric Critical Care,Baylor College of Medicine,Houston,TX"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,2,17]]},"reference":[{"key":"hep30204-bib-0001-20241017","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1136\/gut.2006.112177","article-title":"Cardiovascular complications of cirrhosis","volume":"57","year":"2008","journal-title":"Gut"},{"key":"hep30204-bib-0002-20241017","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1053\/j.gastro.2011.06.082","article-title":"Cardiac structural and functional alterations in infants and children with biliary atresia, listed for liver transplantation","volume":"141","year":"2011","journal-title":"Gastroenterology"},{"key":"hep30204-bib-0003-20241017","first-page":"295","article-title":"Cirrhotic cardiomyopathy","volume":"3","year":"2009","journal-title":"Hepatol Int"},{"key":"hep30204-bib-0004-20241017","first-page":"530","article-title":"Cardiac abnormalities in liver cirrhosis","volume":"151","year":"1989","journal-title":"West J Med"},{"key":"hep30204-bib-0005-20241017","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1007\/s12072-014-9544-6","article-title":"Diastolic cardiac dysfunction is a predictor of dismal prognosis in patients with liver cirrhosis","volume":"8","year":"2014","journal-title":"Hepatol Int"},{"key":"hep30204-bib-0006-20241017","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1111\/liv.13287","article-title":"Survival at 2 years among liver cirrhotic patients is influenced by left atrial volume and left ventricular mass","volume":"37","year":"2017","journal-title":"Liver Int"},{"key":"hep30204-bib-0007-20241017","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.jhep.2004.09.008","article-title":"Cardiac alterations in cirrhosis: reversibility after liver transplantation","volume":"42","year":"2005","journal-title":"J Hepatol"},{"key":"hep30204-bib-0008-20241017","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.jjcc.2015.04.016","article-title":"Cirrhotic cardiomyopathy in the pre\u2010 and post\u2010liver transplantation phase","volume":"67","year":"2016","journal-title":"J Cardiol"},{"key":"hep30204-bib-0009-20241017","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1002\/hep.29520","article-title":"Cardiovascular predictors of death in patients with cirrhosis","volume":"68","year":"2018","journal-title":"Hepatology"},{"key":"hep30204-bib-0010-20241017","doi-asserted-by":"crossref","first-page":"507","DOI":"10.4254\/wjh.v7.i3.507","article-title":"Cirrhotic cardiomyopathy: implications for the perioperative management of liver transplant patients","volume":"7","year":"2015","journal-title":"World J Hepatol"},{"key":"hep30204-bib-0011-20241017","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.jhep.2010.02.023","article-title":"Cirrhotic cardiomyopathy","volume":"53","year":"2010","journal-title":"J Hepatol"},{"key":"hep30204-bib-0012-20241017","article-title":"Biliary atresia: clinical and research challenges for the 21st century","journal-title":"Hepatology"},{"key":"hep30204-bib-0013-20241017","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1111\/j.1399-3046.2008.00909.x","article-title":"Impact of liver transplantation on rate\u2010corrected QT interval and myocardial function in children with chronic liver disease","volume":"13","year":"2009","journal-title":"Pediatr Transplant"},{"key":"hep30204-bib-0014-20241017","doi-asserted-by":"crossref","first-page":"3328","DOI":"10.1016\/j.transproceed.2016.08.049","article-title":"Pretransplant left ventricular dysfunction adversely affects perioperative outcomes in pediatric liver transplantation: a retrospective observational study","volume":"48","year":"2016","journal-title":"Transplant Proc"},{"key":"hep30204-bib-0015-20241017","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1007\/s12072-015-9674-5","article-title":"Cardiac abnormalities in cirrhotic children: pre\u2010 and post\u2010liver transplantation","volume":"10","year":"2016","journal-title":"Hepatol Int"},{"key":"hep30204-bib-0016-20241017","doi-asserted-by":"crossref","first-page":"112","DOI":"10.3748\/wjg.v22.i1.112","article-title":"Left ventricular function assessment in cirrhosis: current methods and future directions","volume":"22","year":"2016","journal-title":"World J Gastroenterol"},{"key":"hep30204-bib-0017-20241017","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.bpg.2006.06.003","article-title":"Cardiac dysfunction in cirrhosis","volume":"21","year":"2007","journal-title":"Best Pract Res Clin Gastroenterol"},{"key":"hep30204-bib-0018-20241017","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1161\/CIRCIMAGING.112.000175","article-title":"Interpretation of left ventricular diastolic dysfunction in children with cardiomyopathy by echocardiography: problems and limitations","volume":"6","year":"2013","journal-title":"Circ Cardiovasc Imaging"},{"key":"hep30204-bib-0019-20241017","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1097\/00003246-199605000-00004","article-title":"PRISM III: an updated Pediatric Risk of Mortality score","volume":"24","year":"1996","journal-title":"Crit Care Med"},{"key":"hep30204-bib-0020-20241017","first-page":"577","article-title":"Recommendations on the use of echocardiography in adult hypertension: a report from the European Association of Cardiovascular Imaging (EACVI) and the American Society of Echocardiography (ASE)","volume":"16","year":"2015","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"hep30204-bib-0021-20241017","doi-asserted-by":"crossref","first-page":"2008","DOI":"10.1002\/hep.30040","article-title":"Cirrhotic cardiomyopathy after transplantation: neither the transient nor innocent bystander","volume":"68","year":"2018","journal-title":"Hepatology"},{"key":"hep30204-bib-0022-20241017","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1002\/lt.25076","article-title":"Pediatric cirrhotic cardiomyopathy: impact on liver transplant outcomes","volume":"24","year":"2018","journal-title":"Liver Transplant"},{"key":"hep30204-bib-0023-20241017","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1111\/ctr.12778","article-title":"Impact and persistence of cirrhotic cardiomyopathy after liver transplantation","volume":"30","year":"2016","journal-title":"Clin Transplant"},{"key":"hep30204-bib-0024-20241017","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1002\/lt.24768","article-title":"Cirrhotic cardiomyopathy: implications for liver transplantation","volume":"23","year":"2017","journal-title":"Liver Transplant"},{"key":"hep30204-bib-0025-20241017","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1016\/S0002-9149(99)80175-1","article-title":"Effect of heart rate on left ventricular diastolic filling patterns assessed by Doppler echocardiography in normal infants","volume":"76","year":"1995","journal-title":"Am J Cardiol"},{"key":"hep30204-bib-0026-20241017","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/S1665-2681(19)31544-3","article-title":"Anatomical cardiac alterations in liver cirrhosis: an autopsy study","volume":"10","year":"2011","journal-title":"Ann Hepatol"},{"key":"hep30204-bib-0027-20241017","doi-asserted-by":"crossref","first-page":"1732","DOI":"10.1002\/hep.26509","article-title":"Diastolic dysfunction is a predictor of poor outcomes in patients with cirrhosis, portal hypertension and a normal creatinine","volume":"58","year":"2013","journal-title":"Hepatology"},{"key":"hep30204-bib-0028-20241017","doi-asserted-by":"crossref","first-page":"2403","DOI":"10.1097\/HJH.0b013e3283593029","article-title":"Prognostic value of the extent of left ventricular hypertrophy and its evolution in the hypertensive patient","volume":"30","year":"2012","journal-title":"J Hypertens"},{"key":"hep30204-bib-0029-20241017","doi-asserted-by":"crossref","first-page":"2768","DOI":"10.1681\/ASN.V12122768","article-title":"Prognostic impact of the indexation of left ventricular mass in patients undergoing dialysis","volume":"12","year":"2001","journal-title":"J Am Soc Nephrol"},{"key":"hep30204-bib-0030-20241017","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1097\/HJH.0000000000000658","article-title":"Risk of mortality in relation to an updated classification of left ventricular geometric abnormalities in a general population: the PAMELA study","volume":"33","year":"2015","journal-title":"J Hypertens"},{"key":"hep30204-bib-0031-20241017","first-page":"1","article-title":"Clinical correlates and prognostic significance of change in standardized left ventricular mass in a community\u2010based cohort of African Americans","volume":"4","year":"2015","journal-title":"J Am Heart Assoc"},{"key":"hep30204-bib-0032-20241017","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1161\/HYPERTENSIONAHA.111.00904","article-title":"Relationship of left ventricular hypertrophy and diastolic function with cardiovascular and renal outcomes in African Americans with hypertensive chronic kidney disease","volume":"62","year":"2013","journal-title":"Hypertension"},{"key":"hep30204-bib-0033-20241017","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1161\/01.CIR.55.4.613","article-title":"Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method","volume":"55","year":"1977","journal-title":"Circulation"},{"key":"hep30204-bib-0034-20241017","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1016\/j.echo.2005.10.005","article-title":"Recommendations for chamber quantification: a report from the American Society of Echocardiography\u2019s guidelines and standards committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiograph","volume":"18","year":"2005","journal-title":"J Am Soc Echocardiogr"},{"key":"hep30204-bib-0035-20241017","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1016\/0735-1097(92)90385-Z","article-title":"Left ventricular mass and body size in normotensive children and adults: assessment of allometric relations and impact of overweight","volume":"20","year":"1992","journal-title":"J Am Coll Cardiol"},{"key":"hep30204-bib-0036-20241017","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1016\/S0002-9149(99)80200-8","article-title":"Indexing left ventricular mass to account for differences in body size in children and adolescents without cardiovascular disease","volume":"76","year":"1995","journal-title":"Am J Cardiol"},{"key":"hep30204-bib-0037-20241017","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/j.echo.2009.03.003","article-title":"Age\u2010specific reference intervals for indexed left ventricular mass in children","volume":"22","year":"2009","journal-title":"J Am Soc Echocardiogr"},{"key":"hep30204-bib-0038-20241017","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1002\/hep.29163","article-title":"Assessment of systolic function in the evaluation of patients with cirrhosis","volume":"65","year":"2017","journal-title":"Hepatology"},{"key":"hep30204-bib-0039-20241017","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1016\/j.jcmg.2014.05.008","article-title":"The natural history of left ventricular geometry in the community: clinical correlates and prognostic significance of change in LV geometric pattern","volume":"7","year":"2014","journal-title":"JACC Cardiovasc Imaging"},{"key":"hep30204-bib-0040-20241017","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1111\/j.1399-3046.2012.01677.x","article-title":"The impact of hepatic portoenterostomy on liver transplantation for the treatment of biliary atresia: early failure adversely affects outcome","volume":"16","year":"2012","journal-title":"Pediatr Transplant"}],"container-title":["Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhep.30204","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01515467-201903000-00028","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,17]],"date-time":"2024-10-17T19:35:57Z","timestamp":1729193757000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01515467-201903000-00028"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,17]]},"references-count":40,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.1002\/hep.30204","relation":{},"ISSN":["0270-9139","1527-3350"],"issn-type":[{"value":"0270-9139","type":"print"},{"value":"1527-3350","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,17]]},"assertion":[{"value":"2018-01-29","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-07-28","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}