{"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":1791893983646,"version":"4.3.4"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2022,1,21]],"date-time":"2022-01-21T00:00:00Z","timestamp":1642723200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatol Commun"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:p>\n                    Cirrhotic cardiomyopathy (CCM), detected during two\u2010dimensional echocardiography (2DE), is prevalent in patients with biliary atresia (BA) awaiting transplant. Whether CCM occurs early in the lives of infants with BA is unknown. The aim of this study was to explore the incidence and consequence of CCM in patients with BA, focusing on the earliest ages when 2DE was performed. A cohort of 78 patients with BA at a single center underwent 2DE (median age\u00a0=\u00a0132\u00a0days) during the first year of life. Left ventricular mass index (LVMI) to upper limit of normal (ULN) ratio\u00a0\u2265\u00a01.0 was present in 60% of patients who never underwent Kasai portoenterostomy (KPE; n\u00a0=\u00a015), 49% with nondraining KPE (n\u00a0=\u00a041), and 21% with draining KPE (n\u00a0=\u00a019). Patients with a draining KPE (median age at 2DE\u00a0=\u00a072\u00a0days) had a lower LVMI\/ULN ratio (0.75 [interquartile range [IQR] 0.70, 0.91]) compared to those with a nondraining KPE (0.99 [IQR 0.78, 1.17] median age of 141\u00a0days;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u00a0=\u00a00.012). In those whose 2DE was performed within 7\u00a0days of KPE (n\u00a0=\u00a019, median age of 61\u00a0days), the LVMI\/ULN ratio was lower in those with a future draining KPE (0.73 [IQR 0.66, 0.75]) compared to the group with a future nondraining KPE (1.03 [IQR 0.88, 1.08],\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u00a0=\u00a00.002). Logistic regression modeling revealed LVMI\/ULN ratio\u00a0\u2265\u00a01.0 as a predictor of KPE outcome, with an odds ratio of 16.7 (95% confidence interval 1.36\u2010204;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u00a0=\u00a00.028) for a future nondraining KPE compared to those with a LVMI\/ULN ratio\u00a0&lt;\u00a01.0.\n                    <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic>\n                    2DE early in the lives of patients with BA revealed features of CCM that correlated with future outcomes. If validated in a multicenter study, this could lead to 2DE as a useful clinical tool in the care of infants with BA.\n                  <\/jats:p>","DOI":"10.1002\/hep4.1890","type":"journal-article","created":{"date-parts":[[2022,1,21]],"date-time":"2022-01-21T06:55:20Z","timestamp":1642748120000},"page":"1413-1424","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":11,"title":["Features of Cirrhotic Cardiomyopathy Early in the Lives of Infants With Biliary Atresia Correlate With Outcomes Following Kasai Portoenterostomy"],"prefix":"10.1097","volume":"6","author":[{"given":"Jhavene","family":"Morrison","sequence":"first","affiliation":[{"name":"Division of Pediatric Critical Care,Children\u2019s Healthcare of Atlanta and Emory University School of Medicine,Atlanta,GA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Division of Cardiology,Sibley Heart Center and Emory University School of Medicine,Atlanta,GA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Figueroa","sequence":"additional","affiliation":[{"name":"Pediatric Biostatistics Core,Emory University School of Medicine,Atlanta,GA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3379-7592","authenticated-orcid":false,"given":"Saul J.","family":"Karpen","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology,Hepatology and Nutrition,Children\u2019s Healthcare of Atlanta and Emory University School of Medicine,Atlanta,GA,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,1,21]]},"reference":[{"key":"hep41890-bib-0001-20251121","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1172\/JCI102813","article-title":"The cardiac output at rest in Laennec's cirrhosis","volume":"32","year":"1953","journal-title":"J Clin Invest"},{"key":"hep41890-bib-0002-20251121","first-page":"530","article-title":"Cardiac abnormalities in liver cirrhosis","volume":"151","year":"1989","journal-title":"West J Med"},{"key":"hep41890-bib-0003-20251121","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1002\/hep.510240226","article-title":"Cirrhotic cardiomyopathy: getting to the heart of the matter","volume":"24","year":"1996","journal-title":"Hepatology"},{"key":"hep41890-bib-0004-20251121","doi-asserted-by":"crossref","first-page":"3026","DOI":"10.1111\/j.1572-0241.2000.03249.x","article-title":"Is there a cirrhotic cardiomyopathy?","volume":"95","year":"2000","journal-title":"Am J Gastroenterol"},{"key":"hep41890-bib-0005-20251121","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1007\/s12072-008-9109-7","article-title":"Cirrhotic cardiomyopathy","volume":"3","year":"2009","journal-title":"Hepatol Int"},{"key":"hep41890-bib-0006-20251121","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1016\/j.jhep.2018.01.006","article-title":"Cirrhotic cardiomyopathy","volume":"69","year":"2018","journal-title":"J Hepatol"},{"key":"hep41890-bib-0007-20251121","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":"hep41890-bib-0008-20251121","doi-asserted-by":"crossref","first-page":"78","DOI":"10.2174\/1573403X15666190509084519","article-title":"Cirrhotic cardiomyopathy: the interplay between liver and cardiac muscle. How does the cardiovascular system react when the liver is diseased?","volume":"17","year":"2021","journal-title":"Curr Cardiol Rev"},{"key":"hep41890-bib-0009-20251121","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":"hep41890-bib-0010-20251121","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":"hep41890-bib-0011-20251121","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 Transpl"},{"key":"hep41890-bib-0012-20251121","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":"hep41890-bib-0013-20251121","doi-asserted-by":"crossref","first-page":"85","DOI":"10.4097\/kjae.2018.71.2.85","article-title":"Cardiovascular dysfunction and liver transplantation","volume":"71","year":"2018","journal-title":"Korean J Anesthesiol"},{"key":"hep41890-bib-0014-20251121","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":"hep41890-bib-0015-20251121","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":"hep41890-bib-0016-20251121","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1002\/hep.29905","article-title":"Biliary atresia: clinical and research challenges for the twenty\u2010first century","volume":"68","year":"2018","journal-title":"Hepatology"},{"key":"hep41890-bib-0017-20251121","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":"hep41890-bib-0018-20251121","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1097\/MPG.0000000000000580","article-title":"Investigation of cardiomyopathy in children with cirrhotic and noncirrhotic portal hypertension","volume":"60","year":"2015","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"hep41890-bib-0019-20251121","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":"hep41890-bib-0020-20251121","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1002\/hep.30204","article-title":"Clinical consequences of cardiomyopathy in children with biliary atresia requiring liver transplantation","volume":"69","year":"2019","journal-title":"Hepatology"},{"key":"hep41890-bib-0021-20251121","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.jpeds.2015.11.058","article-title":"Total serum bilirubin within 3 months of hepatoportoenterostomy predicts short\u2010term outcomes in biliary atresia","volume":"170","year":"2016","journal-title":"J Pediatr"},{"key":"hep41890-bib-0022-20251121","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":"hep41890-bib-0023-20251121","article-title":"Reference values for pulse wave Doppler and tissue Doppler imaging in pediatric echocardiography","volume":"8","year":"2015","journal-title":"Circ Cardiovasc Imaging"},{"key":"hep41890-bib-0024-20251121","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":"hep41890-bib-0025-20251121","doi-asserted-by":"crossref","first-page":"1464","DOI":"10.1111\/liv.12438","article-title":"Cardiomyopathy reverses with recovery of liver injury, cholestasis and cholanemia in mouse model of biliary fibrosis","volume":"35","year":"2015","journal-title":"Liver Int"},{"key":"hep41890-bib-0026-20251121","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1002\/hep.28890","article-title":"Bile acid excess induces cardiomyopathy and metabolic dysfunctions in the heart","volume":"65","year":"2017","journal-title":"Hepatology"},{"key":"hep41890-bib-0027-20251121","doi-asserted-by":"crossref","first-page":"1420","DOI":"10.1111\/liv.13394","article-title":"Bile acids and cardiovascular function in cirrhosis","volume":"37","year":"2017","journal-title":"Liver Int"},{"key":"hep41890-bib-0028-20251121","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1111\/j.1478-3231.2012.02803.x","article-title":"Cardiovascular abnormalities in obstructive cholestasis: the possible mechanisms","volume":"33","year":"2013","journal-title":"Liver Int"},{"key":"hep41890-bib-0029-20251121","doi-asserted-by":"crossref","first-page":"1446","DOI":"10.1073\/pnas.1214608110","article-title":"Cardiomyocyte proliferation contributes to heart growth in young humans","volume":"110","year":"2013","journal-title":"Proc Natl Acad Sci U S A"},{"key":"hep41890-bib-0030-20251121","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.yjmcc.2016.06.001","article-title":"Physiological and pathological cardiac hypertrophy","volume":"97","year":"2016","journal-title":"J Mol Cell Cardiol"},{"key":"hep41890-bib-0031-20251121","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1007\/s00204-015-1477-x","article-title":"Pathophysiology of cardiac hypertrophy and heart failure: signaling pathways and novel therapeutic targets","volume":"89","year":"2015","journal-title":"Arch Toxicol"},{"key":"hep41890-bib-0032-20251121","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1002\/ejhf.942","article-title":"Immune mechanisms in heart failure","volume":"19","year":"2017","journal-title":"Eur J Heart Fail"},{"key":"hep41890-bib-0033-20251121","doi-asserted-by":"crossref","first-page":"15492","DOI":"10.3748\/wjg.v20.i42.15492","article-title":"Cirrhotic cardiomyopathy: a cardiologist's perspective","volume":"20","year":"2014","journal-title":"World J Gastroenterol"},{"key":"hep41890-bib-0034-20251121","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":"hep41890-bib-0035-20251121","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1016\/j.jpedsurg.2012.10.010","article-title":"Aspartate aminotransferase\u2010to\u2010platelet ratio index (APRi) in infants with biliary atresia: prognostic value at presentation","volume":"48","year":"2013","journal-title":"J Pediatr Surg"},{"key":"hep41890-bib-0036-20251121","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1097\/MPG.0b013e3181da1d98","article-title":"Assessment of liver fibrosis and cirrhosis by aspartate aminotransferase\u2010to\u2010platelet ratio index in children with biliary atresia","volume":"51","year":"2010","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"hep41890-bib-0037-20251121","doi-asserted-by":"crossref","first-page":"5893","DOI":"10.3748\/wjg.v21.i19.5893","article-title":"Validation of aspartate aminotransferase to platelet ratio for diagnosis of liver fibrosis and prediction of postoperative prognosis in infants with biliary atresia","volume":"21","year":"2015","journal-title":"World J Gastroenterol"},{"key":"hep41890-bib-0038-20251121","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1097\/MPG.0000000000002446","article-title":"Management of biliary atresia in France 1986 to 2015: long\u2010term results","volume":"69","year":"2019","journal-title":"J Pediatr Gastroenterol Nutr"}],"container-title":["Hepatology Communications"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hep4.1890","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hep4.1890","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1002\/hep4.1890","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T15:00:16Z","timestamp":1763737216000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1002\/hep4.1890"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,21]]},"references-count":38,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1002\/hep4.1890","relation":{},"ISSN":["2471-254X","2471-254X"],"issn-type":[{"value":"2471-254X","type":"print"},{"value":"2471-254X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,21]]},"assertion":[{"value":"2021-09-26","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-21","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}