{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T10:42:41Z","timestamp":1774262561457,"version":"3.50.1"},"reference-count":34,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T00:00:00Z","timestamp":1739750400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Background: To date, little is known about correlations between liver dysfunction and circulatory and cardiac abnormalities (e.g.,: mitral valve, MV) in patients with chronic liver disease (CLD). This study aimed to assess a potential parallelism between liver dysfunction and cardiovascular involvement and identify the factors associated with structural and functional MV disorders. Methods. Among 995 patients with CLD, 346 were enrolled and compared with 168 controls without liver disease. According to the degree of liver disease, patients were classified as patients with chronic hepatitis (142) or with liver cirrhosis (Child-A: 70; Child-B: 65; Child-C: 69). Results: Among the chronic hepatitis group, resting heart rate (HR) and left ventricular (LV) mass were higher than in the control group (p = 0.0008), whereas systemic vascular resistance (SVR) was lower (p = 0.01). Among cirrhotic patients, resting HR, left atrium dimensions\/volumes, LV walls thickness, LV mass, cardiac output (CO), isovolumetric relaxation time (IVRT), deceleration time (DT) and prevalence of aortic stenosis were higher than in non-cirrhotic patients (p = 0.02), whereas the e\/a ratio and SVR were lower (p = 0.0001). Among Child-B\/C, CO, IVRT, DT, prevalence of MV regurgitation and MV calcification score were higher than in the remaining patients (p = 0.02), whereas SVR was lower (p &lt; 0.0001). Among cirrhotic patients with MV regurgitation, Child\u2013Pugh score, liver disease duration, resting HR, left chambers dimensions\/mass, CO, IVRT, DT and MV calcification score were higher compared to patients without regurgitation (p &lt; 0.000), whereas mean blood pressure, e\/a ratio and SVR were lower (p = 0.008). At multivariate analysis, Child\u2013Pugh score, liver disease duration, left chambers volume\/mass and MV calcification score were independently associated with MV regurgitation in cirrhotic patients. Child\u2013Pugh score and MV calcification score strongly correlated in cirrhotic patients (r = 0.68, 95% CI 0.60\u20130.75, p &lt; 0.0001). Conclusions: The magnitude of cardiac morpho\/functional abnormalities is associated with the severity of liver dysfunction. Structural and functional MV abnormalities could represent a novel sign of cardiac involvement in liver cirrhosis. The severity and duration of liver disease, the enlargement of cardiac chambers and leaflet calcium accumulation could play a key role.<\/jats:p>","DOI":"10.3390\/jcdd12020076","type":"journal-article","created":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T11:31:17Z","timestamp":1739791877000},"page":"76","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Cross-Talk Between the Heart and the Liver: The Involvement of the Mitral Valve as a Novel Actor upon the Ancient Scene of Liver Cirrhosis"],"prefix":"10.3390","volume":"12","author":[{"given":"Domenico","family":"Cozzolino","sequence":"first","affiliation":[{"name":"Department of Precision Medicine, \u201cLuigi Vanvitelli\u201d University of Campania, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3320-3878","authenticated-orcid":false,"given":"Riccardo","family":"Nevola","sequence":"additional","affiliation":[{"name":"Liver Unit, AORN S. G. Moscati, \u201cA. Landolfi\u201d Hospital, 83029 Solofra, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Ruggiero","sequence":"additional","affiliation":[{"name":"Cardiology Unit, S. Anna and S. Sebastiano Hospital, 81100 Caserta, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5807-6601","authenticated-orcid":false,"given":"Ciro","family":"Romano","sequence":"additional","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, \u201cLuigi Vanvitelli\u201d University of Campania, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppina Rosaria","family":"Umano","sequence":"additional","affiliation":[{"name":"Department of the Woman, Child, and General and Specialized Surgery, \u201cLuigi Vanvitelli\u201d University of Campania, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0452-3282","authenticated-orcid":false,"given":"Ernesto","family":"Aitella","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Public Health, Life and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5099-3790","authenticated-orcid":false,"given":"Celestino","family":"Sardu","sequence":"additional","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, \u201cLuigi Vanvitelli\u201d University of Campania, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aldo","family":"Marrone","sequence":"additional","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, \u201cLuigi Vanvitelli\u201d University of Campania, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9059-6121","authenticated-orcid":false,"given":"Sandro","family":"Gentile","sequence":"additional","affiliation":[{"name":"Nefrocenter Research, 80141 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1172\/JCI102813","article-title":"The cardiac output at rest in Laennec cirrhosis","volume":"32","author":"Kowalski","year":"1953","journal-title":"J. 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