In response to the article "Evaluation of Cardiac Function in Children Undergoing Liver Transplantation" by Bansal et al., I admire the authors for their valuable insights in evaluating biventricular heart function in pediatric patients undergoing Liver Transplantation. However, I bring up several key concerns regarding study's methodology. The diversity of the pediatric cirrhosis population is limited by the study's small sample size, which consists of only 35 children patients. Advanced diagnostic techniques including tissue Doppler echocardiography and cardiovascular magnetic resonance (CMR), which are valuable for diagnosis of heart diseases, are not included in the study. The lack of a reference group of patients without cirrhosis makes it more difficult to confirm whether the cardiac dysfunction shown is unique to cirrhosis or indicates other chronic disease. Additionally, the study does not provides information regarding the outcomes following liver transplantation especially reversibility of cardaic abnormalities.
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