Effect of Dexmedetomidine on Incidence of Hypertension Following Repair of Coarctation of the Aorta.

OBJECTIVE: Recent literature suggests a potential role for dexmedetomidine in reducing the incidence and severity of hypertension following repair of coarctation of the aorta (CoA). The primary aim of this study was to assess the association between dexmedetomidine use and the incidence of hypertension following repair of CoA in pediatric patients. METHODS: This was a single-center, retrospective cohort study in patients younger than 19 years who underwent surgical repair of CoA between January 1, 2016, and September 30, 2021. Patients were divided into 2 groups: dexmedetomidine initiation within the first 3 hours after surgery or no dexmedetomidine. The primary outcome was incidence of hypertension within the first 4 to 24 hours after repair. Secondary outcomes included the incidence of hypotension and bradycardia. RESULTS: A total of 80 patients were included, 25 (31.25%) received dexmedetomidine. Median age at the time of procedure was 26 days (IQR, 13-241) in the dexmedetomidine group and 14 days (IQR, 8-53) in the no dexmedetomidine group (p = 0.014). The primary outcome of hypertension was met in 7 patients (28%) in the dexmedetomidine group and 12 patients (21.8%) in the no dexmedetomidine group, p = 0.547. The only variable found to be associated with the incidence of hypertension was age greater than 30 days at the time of procedure. More patients who received dexmedetomidine experienced bradycardia. There was no difference in the incidence of hypotension. CONCLUSIONS: There was no association between the use of dexmedetomidine and the incidence of -hypertension following repair of CoA in pediatric patients.

Ultralow-dose binary oncolytic/helper-dependent adenovirus promotes antitumor activity in preclinical and clinical studies.

We show that a binary oncolytic/helper-dependent adenovirus (CAdVEC) that both lyses tumor cells and locally expresses the proinflammatory cytokine IL-12 and PD-L1 blocking antibody has potent antitumor activity in humanized mouse models. On the basis of these preclinical studies, we treated four patients with a single intratumoral injection of an ultralow dose of CAdVEC (NCT03740256), representing a dose of oncolytic adenovirus more than 100-fold lower than used in previous trials. While CAdVEC caused no significant toxicities, it repolarized the tumor microenvironment with increased infiltration of CD8 T cells. A single administration of CAdVEC was associated with both locoregional and abscopal effects on metastases and, in combination with systemic administration of immune checkpoint antibodies, induced sustained antitumor responses, including one complete and two partial responses. Hence, in both preclinical and clinical studies, CAdVEC is safe and even at extremely low doses is sufficiently potent to induce significant tumor control through oncolysis and immune repolarization.

Sex differences in Cardiovascular risk factors and management in a preventive Cardiology clinic at a tertiary referral center

Background@#Cardiovascular disease is the leading cause of death in both genders worldwide. Gender differences in clinical presentation and treatment have been reported.@*Objective@#This study aims to describe and compare the cardiovascular risk factors and management strategies for primary prevention among Filipinos.@*Methods@#An analytical cross-sectional study was done on 2,082 patients at the Preventive Cardiology Clinic of a tertiary referral center in Quezon City, Philippines from January 1, 2002 to December 31, 2017.@*Results@# Seventy-two percent of the patients were females with a higher mean age compared to males (57.67 + 10.50 vs 55.66 + 11.82, p 0.002). There were more women who were unemployed (75.2 vs 45.9, p<0.001). There was no significant difference in the prevalence of hypertension (68.6% vs 67.9%, p=0.542) and type 2 diabetes mellitus (19.8% vs 21.5%, p=0.437) in both genders. Beta blockers (24.1%), calcium channel blockers (22.9%) and angiotensin receptor blockers (22.1%) were the most commonly prescribed anti-hypertensive drugs. Biguanides were the most commonly prescribed glucose-lowering drug (11.3%). Compared to men, more women had dyslipidemia (51.8% vs 38.6%, p<0.001). Statins were more commonly prescribed in women (22.4 vs 18.1%, p=0.033).@*Conclusion@#There were significantly more women seen in our Preventive Cardiology clinic. Smoking and alcoholic drinking were higher in males. BMI, total cholesterol and HDL were significantly higher in females than in males.

Photomediated post-fabrication modification of azlactone-functionalized gels for the development of hydrogel actuators.

We report an approach for the photomediated post-fabrication modification of reactive, azlactone-containing gels using light-initiated deprotection of amines caged with 2-(nitrophenyl)propyloxycarbonyl (NPPOC). Photomediated modification of these gels can be used to generate a gradient in chemical functionality. When functionalized with tertiary amine groups, these gradient gels exhibit rapid and reversible shape deformations in response to changes in pH.

Prevalence and Factors Associated with Obesity at a Primary Preventive Cardiology Clinic: The Philippine Heart Center Experience

@#INTRODUCTION: Obesity has been linked to the development of type 2 diabetes mellitus (T2DM) and cardiovascular diseases. This study primarily aims to determine the prevalence of obesity among the Filipino patients in our institution since there have been no previous studies on this subset of patients. METHODS: A cross-sectional analytical study of 2,078 patients at the Primary Preventive Cardiology Out-Patient Clinic of the Philippine Heart Center (PHC) was done from January 1, 2002 to December 31, 2017. The prevalence of obesity was determined using the World Health Organization (WHO) and Asian classification. Factors associated with obesity were determined using binary logistic regression analysis. RESULTS: A majority of the patients were females (1499, 71.14%) with a higher mean age compared to the male patients (57.67±10.5 vs 55.66±11.8, p<0.001). Hypertension (68.5%), coronary artery disease (37.1%) and T2DM (20.3%) were the most common co-morbid illnesses in both genders. The mean body mass index (BMI) was 25.8±4.3 kg/m2 for the female patients while it was 25.2±4.1 kg/m2 for the male patients (p<0.001). The prevalence of obesity using the WHO and Asian classifications was 15% (n=312). Compared to the Asian criteria, there were significantly more patients classified as having normal weight (44.09% vs 24.95%, p<0.001) and overweight (37.98% vs 19.13%, p<0.001) using the WHO classification. Pre-obesity, an additional criterion of the Asian classification which was not adopted by WHO was seen in 37.98% of the patients. On multivariate analysis, female gender (OR 1.31, 95% CI [1.08-1.59)] p=0.006) and T2DM (OR 1.25, 95% CI [1.01-1.56], p=0.42) were significant factors associated with obesity while age (OR 0.98, 95% CI [0.98-0.99], p<0.001) was protective of obesity. CONCLUSION: The prevalence of obesity in our cohort was consistent with the worldwide prevalence reported by the WHO which underscores the need for effective weight management programs and primary preventive strategies 7to lower the prevalence and obviate the development of complications related to obesity. Female gender and T2DM were significant factors associated with obesity, while age was a significant protective factor of obesity.

A Magnetically Tunable Check Valve Applied to a Lab-on-Chip Nitrite Sensor.

Presented here is the fabrication and characterization of a tunable microfluidic check valve for use in marine nutrient sensing. The ball-style valve makes use of a rare-earth permanent magnet, which exerts a pulling force to ensure it remains passively sealed until the prescribed cracking pressure is met. By adjusting the position of the magnet, the cracking pressure is shown to be customizable to meet design requirements. Further applicability is shown by integrating the valve into a poly(methyl methacrylate) (PMMA) lab-on-chip device with an integrated optical absorbance cell for nitrite detection in seawater. Micro-milling is used to manufacture both the valve and the micro-channel structures. The valve is characterized up to a flow rate of 14 mL min-1 and exhibits low leakage rates at high back pressures (<2 µL min-1 at ~350 kPa). It is low cost, requires no power, and is easily implemented on microfluidic platforms.

The Philippines' antidrug campaign: Spatial and temporal patterns of killings linked to drugs.

BACKGROUND: As soon as President Rodrigo Duterte assumed office in 2016, the Philippine government launched a nationwide antidrug campaign based on enforcement-led anti-illegal drugs policies primarily implemented by the national police. This was followed by a spate of killings resulting from both acknowledged police operations and by unidentified assailants. This study assembles a victim-level dataset of drug-related killings covered by the media during the Philippine government's antidrug campaign, and presents a spatial and temporal analysis of the killings. METHODS: The dataset covers information on 5021 people killed from May 10, 2016 to September 29, 2017. Data collected systematically through online search procedures and existing listings of media organizations detailing information about incidences of drug-related police operations and drug-related killings in 'vigilante-style' manner reveal patterns for who were being killed, where, and how. RESULTS: Over half of the killings were due to acknowledged police operations, and the rest were targeted in so-called 'vigilante-style' killings. The first three months after Mr. Duterte was sworn in were the deadliest months. Those who were killed were mostly low-level drug suspects. The analysis of temporal pattern reveals the scale of killings in the country, with rapid escalation starting in July 2016 and lasting throughout the rest of that year. Observable declines occurred during periods when the 'drug war' was suspended and operations were moved to a non-police enforcement unit and rose again when police were brought back into operations. The spatial analysis indicates a large concentration of deaths in the National Capital Region (40%) compared to the rest of the country with wide variations across cities and regions. CONCLUSIONS: Overall, the Philippine 'drug war' exhibits similarities with violent wars on drugs waged in other countries such as Thailand, with heavily police-led interventions leading to fatalities in the thousands over a span of under two years. Findings of this study point to important policy adjustments that need to be made, including the role that local governments play in drug policy implementation, the disproportionate negative impacts of enforcement-led policies against drugs on urban and poor areas, the targeting of low-level suspected drug dealers and users, and the importance of proper data monitoring and transparency by the government to inform policy adjustments in the face of high costs to human life. We also discuss the importance of independent monitoring systems when the government reports conflicting information.

Assessment of the prognostic utility of the FIT treadmill score in coronary artery disease patients undergoing cardiac rehabilitation.

Introduction: Cardiovascular fitness is an important goal in cardiac rehabilitation (CR) programs and is predictive of outcomes. We sought to determine the utility of a novel clinical treadmill score in determining prognosis of coronary artery disease (CAD) patients after CR. Methods: Demographic, clinical and exercise data of 262 patients (mean age 55.8 ± 10.1 years) who completed an outpatient CR program were analyzed. The FIT treadmill score was determined prior to program initiation and after completion. Patients were classified according to risk category using the FIT scores after CR completion and were followed up for the occurrence of 10 year all cause mortality. Results: On median follow up of 10.3 years, 52 patients died. An improvement of the FIT treadmill score by 18.2 points was associated with a 21% reduction in mortality (multivariate-adjusted Hazard Ratio 0.79, 95% CI 0.56-1.08, P≤0.05). Kaplan-Meier survival curves showed increased occurrence of mortality in the high-risk group. After adjustment for confounders a high-risk FIT score category on exit (HR: 2.7, 95% CI 1.41-5.17, P≤0.05) was predictive of increased mortality. Both an improvement in the FIT score (AUC=0.81) and the FIT score category on exit (AUC=0.92) had good discrimination in predicting mortality. Conclusion: The FIT treadmill score is predictive of all cause mortality in patients with CAD undergoing CR. An improvement in the FIT score after CR is associated with improved survival. The FIT score may be a useful prognostic marker of overall cardiovascular fitness and successful outcome for patients who participate in CR programs.

Ten-Year survival analysis of Filipino patients with Systemic Lupus Erythematosus at the National Kidney and Transplant Institute

Introduction@#Systemic lupus erythematosus (SLE) is increasingly being diagnosed in our country. This study aims to describe the clinical features, management strategies and outcome of patients with SLE during a ten-year period.@*Methods@#This is a retrospective cohort study of patients first diagnosed with SLE at the National Kidney and Transplant Institute in 2004 who were then followed up in the next ten years.@*Results@#Eighty-five patients were first diagnosed with SLE in 2004. The mean age was 28.1±12.03 years old. Hypertension (34.12%) was the most common co-morbid illness. Renal involvement (74.12%) was seen in a majority but only those with cardiopulmonary manifestations (mean=0.71 years, p=0.030) significantly affected survival. Eleven patients (12.94%) expired during the study period. Active disease and infection were the most common causes of death. Biopsyproven lupus nephritis had a significantly higher survival rate (mean=10.57 years, p=0.006). Those on hemodialysis had a significantly lower survival time (mean=8.82 years, p=0.040). Discussion: The estimated 10-year cumulative survival rate of patients with SLE in our cohort was 75%. This is comparable to the rates reported in some countries. Regular follow-up at six to eight weeks intervals with more frequent follow-up for patients with an SLE flare and/or on intensive immunosuppression was the most likely reason for studies reporting higher survival rates. The disparity in the survival rates may also be attributed to the frequency of exacerbations with better survival among those who never had exacerbations. The most common cause of death was due to septic shock secondary to pneumonia. The authors believe that one factor that was contributory to death was the degree of immunosuppression as observed in studies describing high doses of corticosteroids on those who have died.@*Conclusion@#The cumulative survival rate decreased from 90% at the time of diagnosis to 75% on the tenth year which was comparable to several countries. Patients with cardiopulmonary manifestations were found to significantly affect survival in this study. Although renal involvement was the most common initial manifestation, it did not significantly affect survival similar to other studies. However, biopsyproven lupus nephritis cases had better survival since this allowed treatment to be streamlined based on the class of lupus nephritis. Active disease and infection were the most common causes of death.

Comparison of the prevalence of Hypertension using three proposed classifications in a single center primary prevention setting

Introduction@#The American College of Cardiology/American Heart Association (ACC/AHA) revised the thresholds for the definition and treatment of hypertension that was recommended by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) while the 2018 European Society of Cardiology/European Society of Hypertension (ESC/ESH) Guidelines for the Prevention, Detection, Evaluation, and Management of High Blood Pressure retained their previous classification but revised the recommendations for diagnosis and treatment. The impact of these changes in our setting is uncertain. This study aims to compare the prevalence of hypertension using the three proposed criteria in a primary preventive setting.@*Methods@#This is a cross-sectional analytical study using data at the Primary Preventive Cardiology Clinic of the Philippine Heart Center from January 1, 2002 to December 31, 2017.@*Results@#There were 2,082 patients in this study. The mean age is 57.1±10.9 years with a female predominance (72.5%). Most of the patients were married (67.3%, 1,401) and unemployed (67.1%, 1,398). Comorbid illnesses include dyslipidemia (48.2%) and type 2 diabetes mellitus (20.3%). The prevalence of hypertension using the JNC 7 and the 2018 ESC/ESH blood pressure (BP) classification was 56% (n=1,167). When the 2017 ACC/AHA BP classification was applied, there was a significant increase in the prevalence of hypertension to 80.3% (n=1671) (p<0.001) demonstrating an absolute increase of +24.2%.@*Conclusion@#The study shows a high prevalence of hypertension which further increased when the 2017 ACC/AHA BP classification was applied This can impose a significant public health burden that needs to be addressed to prevent or decrease hypertension-related complications. Use of the new guidelines may affect diagnosis and treatment of hypertension with potential cost implications.

Left Ventricular Non-Compaction in an adult with Patent Ductus Arteriosus

Introduction@#Left ventricular non-compaction (LVNC) is a rare form of cardiomyopathy that may occur in isolation or with an associated cardiac anomaly. It presents with a wide array of manifestations, prompting early recognition to be imperative to prevent progression of symptoms.@*Case presentation@#We report a case of a 46-year-old male complaining of palpitations for 10 years who survived sudden cardiac arrest on the same year as symptom onset. Consult was advised but was not done until he had heart failure symptoms. Carvedilol, furosemide and digoxin were given. Initially, some improvement was noted but he later developed dyspnea on exertion prompting consult at our institution. Pertinent physical examination findings include a dynamic precordium, apex beat at sixth left intercostal space-anterior axillary line (LICS AAL), right ventricular heave, distinct heart sounds, normal rate, irregularly irregular rhythm, a grade 4/6 continuous murmur heard best at the left upper sternal border, suggestive of patent ductus arteriosus (PDA), and a grade 3/6 holosystolic murmur at the apex radiating to the axilla, suggestive of mitral regurgitation. Transthoracic echocardiography confirmed presence of a PDA (0.8cm) with left to right shunt and Qp/Qs of 2.7:1. Incidental finding of LVNC was noted characterized by prominent ventricular trabeculations and deep intertrabecular recesses. Optimal medical treatment for heart failure was given with symptomatic relief. Surgical closure of the PDA was contemplated after hemodynamic studies can confirm the absence of irreversible pulmonary hypertension.@*Discussion@#Patients with LVNC may be asymptomatic or may present with heart failure, sudden cardiac death or arrhythmias. The diagnosis of LVNC poses a diagnostic challenge. Echocardiography is a cost-effective diagnostic tool that will allow early diagnosis. Cardiac magnetic resonance (CMR) imaging is an alternative diagnostic modality. Once the diagnosis has been confirmed, prompt initiation of guideline-directed medical treatment for heart failure may prevent progression of disease.@*Conclusion@#Left ventricular non-compaction may occur in isolation or in association with other congenital heart diseases such as patent ductus arteriosus. Closure of a PDA is indicated in the presence of a significant shunt and with confirmation of acute reversibility in the presence of pulmonary hypertension to prevent the possibility of decompensation in a patient with heart failure.

Acute Limb Ischemia: A rare and devastating complication of infective Endocarditis

Introduction@#In contrast to embolic events to the brain, lungs and spleen which have been comprehensively discussed in literature, acute limb ischemia (ALI) due to septic embolism (SE) from infective endocarditis (IE) are uncommonly reported. There have been no reported cases of ALI as a complication of IE among Filipinos to date making this case report the first in our country@*Case Presentation@#We report two cases of communityacquired native valve endocarditis caused by streptococcus spp. and enterococcus faecalis. Both patients had large and mobile vegetations in the mitral valve and aortic valve respectively on transthoracic echocardiography. The first one developed ALI (IIa) on the R leg after the initiation of antibiotics. The second case presented with ALI (IIa) on the R leg on admission. They were given the appropriate antibiotics and received systemic anticoagulation with heparin. The first case underwent successful emergency embolectomy on the R leg but developed new-onset ALI on the L leg and refused further intervention. Embolectomy was also recommended on the second patient who also re-fused any intervention. Despite maximal medical management, both patients subsequently expired@*Conclusion@#Infective endocarditis (IE) patients are at risk to develop SE before or during the initiation of appropriate antibiotics. ALI is a life threatening extra cardiac complication of IE. Early recognition and prompt aggressive management are therefore imperative.

Liver Abscess Harbors Melioidosis: A case report on this rare finding in a potentially endemic community

Introduction@#Melioidosis among Filipinos may be underreported. The causative agent, Burkholderia pseudomallei, thrives in soil and water in tropical regions. Because our country thrives on agriculture as a source of livelihood, occupational exposure through farming needs to be recognized. @*Case Presentation@#We report a case of a 40-year-old male complaining of intermittent fever, progressive weight loss and jaundice for three weeks prompting consult. Whole abdominal ultrasound showed presence of a hepatic mass. Further evaluation using CT scan of the whole abdomen with contrast revealed multiple cystic hepatic nodules with wall/septal enhancement. He was admitted and was initially managed as sepsis secondary to a complicated intra-abdominal infection (liver abscess, pyogenic or amebic). Ciprofloxacin and metronidazole were started. Aspiration of the hepatic abscess showed many pus cells. Culture of the aspirate grew Burkholderia pseudomallei, sensitive to ceftazidime. Antibiotics were shifted accordingly. Defervescence ensued. Patient was discharged improved after two weeks of ceftazidime wo grams every eight hours given intravenously followed by a three-month oral course of cotrimoxazole 160mg/800mg tablet, two tablets every 12 hours and doxycycline 150mg capsule every 12 hours. On follow-up after three months, he had no recurrence of symptoms and was able to resume his usual work.@*Discussion@#Melioidosis is a disease of humans and animals that is geographically restricted to tropical countries since the organism thrives in soil and water. Symptom onset may be delayed due to the ability of the organism to produce latent infection. Isolation of B. pseudomallei from clinical specimens sent for culture and sensitivity testing is the diagnostic gold standard.@*Conclusion@#Melioidosis may present as an intraabdominal infection. A high clinical index of suspicion among those with occupational exposure to contaminated soil and water is important to promptly recognize and treat this infection.

A Comparative Effectiveness Study of Two Nontargeted HIV and Hepatitis C Virus Screening Algorithms in an Urban Emergency Department.

STUDY OBJECTIVE: We compare the effectiveness of 2 nontargeted HIV and hepatitis C virus screening protocols integrated consecutively into care in an urban emergency department: a nurse-order HIV/hepatitis C virus screening algorithm followed by an automated-laboratory-order HIV/hepatitis C virus screening algorithm programmed into the electronic health record. METHODS: This was a before-after comparative effectiveness cohort study. All patients aged 18 to 75 years who received treatment during 5-month periods were eligible for participation. The main outcome measures were the number of patients screened and the number with newly diagnosed HIV and hepatitis C virus infection. RESULTS: Of the eligible patients, 6,736 (33.9%) completed HIV screening during the automated-laboratory-order HIV/hepatitis C virus screening algorithm, whereas 4,121 (19.6%) completed HIV screening during the nurse-order HIV/hepatitis C virus screening algorithm (difference 14.3%; 95% confidence interval 13.4% to 15.1%); and 6,972 (35.1%) completed hepatitis C virus screening during the automated-laboratory-order HIV/hepatitis C virus screening algorithm, whereas 2,968 (14.2%) completed hepatitis C virus screening during the nurse-order HIV/hepatitis C virus screening algorithm (difference 20.9%; 95% confidence interval 20.1% to 21.7%). More patients had newly diagnosed HIV (23 versus 17) and hepatitis C virus infection (101 versus 29) during the automated-laboratory-order HIV/hepatitis C virus screening algorithm than the nurse-order HIV/hepatitis C virus screening algorithm. Results were more often available before discharge (HIV 87.2% versus 65.1%; hepatitis C virus 90.0% versus 65.4%) and fewer patients underwent repeated screening (HIV 1.6% versus 5.8%; hepatitis C virus 1.3% versus 4.5%) during the automated-laboratory-order HIV/hepatitis C virus screening algorithm than the nurse-order HIV/hepatitis C virus screening algorithm. CONCLUSION: An electronic health record algorithm that automatically links HIV/hepatitis C virus screening to laboratory ordering for adult patients is more effective than a nurse-driven protocol. With widespread use of electronic health record systems, this model can be easily replicated and should be considered the standard for future programs.

Progress Toward Measles Elimination - Western Pacific Region, 2013-2017.

In 2005, the Regional Committee for the World Health Organization (WHO) Western Pacific Region (WPR)* established a goal for measles elimination† by 2012 (1). To achieve this goal, the 37 WPR countries and areas implemented the recommended strategies in the WPR Plan of Action for Measles Elimination (2) and the Field Guidelines for Measles Elimination (3). The strategies include 1) achieving and maintaining ≥95% coverage with 2 doses of measles-containing vaccine (MCV) through routine immunization services and supplementary immunization activities (SIAs), when required; 2) conducting high-quality case-based measles surveillance, including timely and accurate testing of specimens to confirm or discard suspected cases and detect measles virus for genotyping and molecular analysis; and 3) establishing and maintaining measles outbreak preparedness to ensure rapid response and appropriate case management. This report updates the previous report (4) and describes progress toward measles elimination in WPR during 2013-2017. During 2013-2016, estimated regional coverage with the first MCV dose (MCV1) decreased from 97% to 96%, and coverage with the routine second MCV dose (MCV2) increased from 91% to 93%. Eighteen (50%) countries achieved ≥95% MCV1 coverage in 2016. Seven (39%) of 18 nationwide SIAs during 2013-2017 reported achieving ≥95% administrative coverage. After a record low of 5.9 cases per million population in 2012, measles incidence increased during 2013-2016 to a high of 68.9 in 2014, because of outbreaks in the Philippines and Vietnam, as well as increased incidence in China, and then declined to 5.2 in 2017. To achieve measles elimination in WPR, additional measures are needed to strengthen immunization programs to achieve high population immunity, maintain high-quality surveillance for rapid case detection and confirmation, and ensure outbreak preparedness and prompt response to contain outbreaks.

Cardiac Profile of Filipino Patients With Liver Cirrhosis: A 10-Year Study.

BACKGROUND: Cardiac complications among patients with liver cirrhosis have not yet been described among Filipinos. Cirrhotic cardiomyopathy is a rarely described complication that has not been extensively described in literature. This is the first study to describe the electrocardiographic and echocardiographic findings of Filipino patients with liver cirrhosis. METHODS: A retrospective analytical study of 148 patients with liver cirrhosis from 2007 to 2016 at the Philippine Heart Center was done. The clinical characteristics, median QTc interval, systolic and diastolic functions on echocardiography of these patients were described. Spearman rho correlation was employed to determine the rank order correlation between QTc prolongation and the severity of liver cirrhosis. Fisher's Exact test was used to test the association of the echocardiographic parameters with the severity of liver cirrhosis. RESULTS: The 10-year prevalence rate of liver cirrhosis at the Philippine Heart Center was 0.001% (148/137,584). The mean age was 72.4 ± 14 years with a female/male ratio of 1.1:1. The most common etiology of cirrhosis was hepatitis B or C infection (20%, 29). The Child-Pugh Classification (CPC) and Model for End-Stage Liver Disease (MELD) score were used to determine the severity of liver cirrhosis and to assess their prognosis. There were 31 patients (24%) with CPC-A, 84 patients (64%) with CPC-B and 15 patients (11%) with CPC-C. Fifty-five percent (n = 69) had a MELD score of 16 and below. Prolongation of the QTc interval was only seen among those with CPC A (median QTc of 470 ms) and a MELD score of 9 and below (median QTc of 485 ms). The mean left ventricular ejection fraction was 54.40±28.63%. There were five patients with a left ventricular ejection fraction of < 55%. The mean cardiac output (6.04 ± 5.24 L/min/m2) and cardiac index (2.92 ± 1.47 L/min/m2) were normal. There were 44 patients who had evidence of diastolic dysfunction based on an E/A ratio < 1, prolongation of isovolumic relaxation time (IVRT) of > 80 ms and prolongation of deceleration time (DT) of > 200 ms. There were only five patients who fulfilled the criteria for cirrhotic cardiomyopathy. A majority of the patients were discharged improved (82%). There were 26 cases who expired (18%). CONCLUSION: A higher mean age of Filipinos with liver cirrhosis was reported in our study. Prolongation of the QTc interval was seen among those with early and late stage of cirrhosis (CPC A or MELD score ≤ 9 and CPC C). Most of these patients had normal left ventricular systolic function precluding the presence of cirrhotic cardiomyopathy.