Cirrhotic cardiomyopathy: a systematic review and meta-analysis of prevalence across various diagnostic approaches

BACKGROUND:
Cirrhotic cardiomyopathy (CCM) is a cardiac dysfunction associated with liver cirrhosis, yet no consensus exists on standardized diagnostic criteria. We aimed to assess CCM prevalence using several guidelines.


METHODS:
A systematic search of four databases (PubMed, Embase, Google Scholar, and EBSCO) identified observational studies reporting CCM prevalence in cirrhotic patients based on the three criteria: the World Congress of Gastroenterology (Montreal 2005), the American Society of Echocardiography (ASE 2009), and the Cirrhotic Cardiomyopathy Consortium (CCC 2019). A random-effects meta-analysis and subgroup analyses were performed using R Studio.


RESULTS:

Seventy-six studies including 7445 patients were analyzed. Overall pooled CCM prevalence was 48% (95% CI: 44–52%, I
2
=97%). Prevalence was highest using Montreal 2005 (51%), followed by ASE 2009 (45%) and CCC 2019 (45%). CCC 2019 better identified CCM in early-stage cirrhosis (Child-Pugh A), whereas Montreal 2005 was more sensitive in advanced stages (Child-Pugh C).



CONCLUSION:
CCM prevalence varies by diagnostic criteria and cirrhosis severity. Further studies are needed to determine the clinical relevance and prognostic value of each criterion.


PROSPERO REGISTRATION NUMBER:
CRD42024511527