Comment on “Limited cardiopulmonary capacity in patients with liver cirrhosis when compared to healthy subjects”

Dear editor,

We read an interesting article, written by Nasser et al.¹, entitled “Limited cardiopulmonary capacity in patients with liver cirrhosis when compared to healthy subjects.” In this valuable article, the authors found that the cardiopulmonary capacity of patients with liver cirrhosis was lower than that of healthy subjects. Although there is no obvious controversy over authors’ findings, we still find some issues in this article that are worth discussing.

The objective of this study, as mentioned in summary, was to compare the cardiopulmonary function of patients with cirrhosis and healthy subjects. However, we combine this objective with that mentioned in the conclusion: “To provide reference for the future research, which is recommended to develop an appropriate physical exercise plan for patients with liver cirrhosis, enhance the patient's cardiopulmonary function, and improve the quality of life.“ Therefore, we propose to modify the objective in summary to “compare and analyze the cardiopulmonary function of patients with liver cirrhosis and healthy subjects and provide a reference for improving the survival plan of patients with liver cirrhosis.”

In the last paragraph of introduction, we find the authors described it in this way: “Patients with liver cirrhosis often lack exercise and have a sedentary lifestyle, which may damage their liver function and further harm their health.” Although this conclusion has been confirmed in previous studies², the authors missed adding references to support this statement. We suggest adding the corresponding references here.

In the statistics analysis section, the authors paid attention only to age and gender. No statistically significant difference was found for age in this study; this may be due to other demographic characteristics, such as occupation and residence, which may also affect the comparison results. Thus, these differences should also be considered in the pairing analysis. In addition, sample size in this study is relatively small, with only 19 subjects in each group. Therefore, we recommend using absolute numbers instead of relative numbers in the results section. Also, we suggest to enlarge the sample size as much as possible to better corroborate the results of this experiment.

• Funding: none.

REFERENCES

• ¹
  Nasser I, Miranda H, Perez RM, Cabiddu R, Malosa L, Dias I, et al. Limited cardiopulmonary capacity in patients with liver cirrhosis when compared to healthy subjects. Rev Assoc Med Bras (1992). 2021;67(1):94-100. https://doi.org/10.1590/1806-9282.67.01.20200449
  » https://doi.org/10.1590/1806-9282.67.01.20200449
• ²
  Lemyze M, Dharancy S, Nevière R, Wallaert B. Cardiopulmonary response to exercise in patients with liver cirrhosis and impaired pulmonary gas exchange. Respir Med. 2011;105(10):1550-6. https://doi.org/10.1016/j.rmed.2011.06.011
  » https://doi.org/10.1016/j.rmed.2011.06.011

Publication Dates

• Publication in this collection
  23 Feb 2022
• Date of issue
  Jan 2022

History

• Received
  03 Oct 2021
• Accepted
  18 Oct 2021