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Abstract Background: chronic liver disease (CLD) may affect cardiac performance. We aimed to study the effects of CLD on cardiac electrical functions, structure and function in children suffering from CLD classifying them into two groups ; cholestatic and non-cholestatic. Subjects and Methods: 32 patients (20 males & 16 females; mean age = 7.39 years) with various causes of CLD who were free from any primary cardiac disease and 15 controls of matched age and sex were studied. For all , arterial blood pressure (systolic, diastolic and mean) was measured and: ECG, 2D, M-mode and Doppler echocardiography were done. Patients were then divided into 2 groups: cholestatic (n=16) and non-cholestatic (n=16). Results: The cholestatic patients’ hearts showed significant increase in QTc duration , hyperdynamic contractility, diastolic dysfunction with restrictive filling pattern, increase in LV mass, since most of them are associated with changes in terms of LV geometry in the form of concentric remodling and hypertrophy in the main configuration. In comparison to non cholestatic chronic liver diseases, it seems the latter contributes to cardiac derangement in structure rather than electrical changes. Conclusion: CLD affects cardiac performance in children. Cholestatic children are specifically liable to QTc prolongation, structural changes , hyperdynamic status and diastolic dysfunction |