Greater cirrhosis severity is associated with a higher prevalence of echocardiographically defined cirrhotic cardiomyopathy

Cirrhotic cardiomyopathy (CCM) is a silent but important contributor to adverse outcomes across the liver–heart–kidney axis. We therefore conducted this study to evaluate the association between cirrhosis severity (Child–Pugh and MELD) and echocardiographic cardiac dysfunction defined by the 2019 Cirrhotic Cardiomyopathy Consortium criteria, and to explore candidate Child–Pugh and MELD thresholds associated with CCM as a basis for future validation. We performed a cross-sectional study (September 2023–September 2024) enrolling 77 clinically stable adults with cirrhosis and no prior cardiovascular disease. Clinical, laboratory, and echocardiographic data were collected, with emphasis on impaired left ventricular global longitudinal strain (LVGLS), diastolic dysfunction, and CCM. Exploratory multivariable logistic regression was used to identify factors independently associated with each outcome, and receiver operating characteristic (ROC) analysis was used to explore candidate Child–Pugh and MELD cutoffs for CCM, with optimal values determined by the Youden index. The cohort (mean age 61 ± 10 years; 50.6% male) demonstrated diastolic dysfunction in 49.4%, impaired LVGLS in 28.6%, and CCM in 32.5%. Median Child–Pugh and MELD scores were 6 (IQR 5–8) and 11 (IQR 9–14), with 51.9%, 32.5%, and 15.6% classified as Child–Pugh A, B, and C, respectively. The MELD score emerged as an independent correlate of diastolic dysfunction (aOR = 1.43; 95% CI: 1.15–1.78; p = 0.002), while the Child–Pugh score was independently associated with impaired LVGLS (aOR = 1.30; 95% CI: 1.01–1.68; p = 0.045) and CCM (aOR = 1.33; 95% CI: 1.03–1.72; p = 0.027). ROC analysis identified MELD ≥ 10.5 (AUC 0.708) and Child–Pugh ≥ 8.5 (AUC 0.691) as potential thresholds for identifying patients at higher risk of CCM. Greater cirrhosis severity was associated with a higher likelihood of CCM. The MELD score may be useful for detecting diastolic dysfunction, whereas Child–Pugh score appeared more sensitive in identifying reduced LVGLS and CCM. The cutoffs of MELD ≥ 10.5 and Child–Pugh ≥ 8.5 could serve as preliminary reference points for risk stratification, supporting the consideration of cardiovascular screening in patients with cirrhosis; however, these exploratory thresholds require validation in larger prospective cohorts before clinical application.