Bansal Neha, Ovchinsky Nadia, Mahgerefteh Joseph, Lamour Jacqueline M, Kogan-Liberman Debora, Choueiter Nadine
Division of Pediatric Cardiology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, 3415 Bainbridge Ave- R1, Bronx, NY, 10467, USA.
Division of Pediatric Hepatology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA.
Pediatr Cardiol. 2025 Feb 27. doi: 10.1007/s00246-025-03818-4.
The authors recognize the limitations of our study, most of which are due to being a single-center study and the small sample size of our cohort. We tried to keep our population as homogeneous as possible and included patients only with cirrhosis. Imaging modalities like cardiac MRI, 3D echocardiography, and tissue Doppler imaging as well as exercise testing often give us significantly more information about cardiac function but come with their inherent limitations of requiring general anesthesia, limited availability, and age-dependent variability. We agree with both reviewers that our study lacks the longitudinal aspect which would allow us to study the reversibility of findings post-liver transplantation. However, the purpose of our study was to correlate the pre-transplantation echocardiographic findings as a risk stratification method for post-transplantation clinical measures like duration of mechanical ventilation and length of hospital stay. We believe that the results of our study can serve as a basis for further prospective studies in the evaluation of patients prior to liver transplantation as well as demonstrating reversal of findings in long-term post-transplant period.
作者认识到我们研究的局限性，其中大部分是由于这是一项单中心研究以及我们队列的样本量较小。我们试图使我们的研究人群尽可能同质化，仅纳入肝硬化患者。像心脏磁共振成像、三维超声心动图和组织多普勒成像等影像学检查方式以及运动测试通常能为我们提供关于心脏功能的显著更多信息，但它们存在一些固有局限性，如需要全身麻醉、可用性有限以及存在年龄相关的变异性。我们同意两位审稿人的观点，即我们的研究缺乏纵向研究，而这将使我们能够研究肝移植后各项发现的可逆性。然而，我们研究的目的是将移植前超声心动图检查结果作为一种风险分层方法，用于评估移植后诸如机械通气持续时间和住院时间等临床指标。我们相信，我们的研究结果可以作为进一步前瞻性研究的基础，用于在肝移植前评估患者，并展示移植后长期阶段各项发现的逆转情况。
