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Prolonged QTc Interval Is an Electrophysiological Hallmark of Cirrhotic Cardiomyopathy

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DOI: 10.4236/ojim.2014.41006    3,958 Downloads   5,577 Views   Citations

ABSTRACT

BACKGROUND: Cirrhotic Cardiomyopathy is a relatively ill-characterized condition, which is often under-diagnosed due to absence of defined diagnostic criteria. ECG showing corrected QT Interval prolongation is the most suitable available option for diagnosis of this condition. OBJECTIVE: To determine the frequency of corrected QT interval prolongation in patients with liver cirrhosis. METHODOLOGY: Patients (n = 166) with confirmed cirrhosis, 30 years or older, presented in the outpatient and emergency department of medicine at Capital Hospital Islamabad between 1 October 2011 and 30 September 2012, were enrolled in this cross-sectional study after taking consent. ECG was done using calibrated ECG machine, and the QT Interval was measured. Corrected QT was calculated using Bazett’s formula and a QTc of more than 0.44 seconds was considered as being prolonged. RESULTS: The mean age of the patients was 57.05 ± 12.03 years. The corrected QT Interval varied from 337 ms to 560 ms. The mean QTc Interval was 429.92 ms ± 45.11. QTc was prolonged in 41 out of 166 patients (24.7%). Frequency of QTc prolongation was 4.5% in Child Pugh Grade A, 23.2% in Child Pugh Grade B, and 32.0% in Child Pugh Grade C. Association of Child Pugh Scoring with QTc prolongation was determined and found to be statistically significant (P < 0.05). CONCLUSION: QTc interval was prolonged in 24.7% of cirrhotic patients in our study. There was a significant increase in frequency with worsening of Child Pugh Grade, thereby indicating an association between QTc prolongation and the severity of cirrhosis.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Bashir Bhatti, A. , Ali, F. and Akbar Satti, S. (2014) Prolonged QTc Interval Is an Electrophysiological Hallmark of Cirrhotic Cardiomyopathy. Open Journal of Internal Medicine, 4, 33-39. doi: 10.4236/ojim.2014.41006.

References

[1] Heidelbaugh, J.J. and Bruderly, M. (2006) Cirrhosis and Chronic Liver Failure: Part I. Diagnosis and Evaluation. American Family Physician, 74, 756-62.
[2] Stroffolini, T., Sagnelli, E., Almasio, P., et al. (2004) Characteristics of Liver Cirrhosis in Italy: Results from a Multicenter National Study. Digestive and Liver Disease, 36, 56-60.
http://dx.doi.org/10.1016/j.dld.2003.07.007
[3] Anderson, R.N. And Smith, B.L. (2003) Deaths: Leading Causes for 2001. National Vital Statistics Reports, 52, 1-85.
[4] Haliday, M.L., Coates, R.A. and Rankin, J.G. (1991) Changing Trends of Cirrhosis Mortality in Ontario, Canada 1911-1986. International Journal of Epidemiology, 20, 199-208.
http://dx.doi.org/10.1093/ije/20.1.199
[5] Kowalski, H.J. and Abelmann, W.H. (1953) The Cardiac Output at Rest in Laennec’s Cirrhosis. Journal of Clinical Investigation, 32, 1025-1033. http://dx.doi.org/10.1172/JCI102813
[6] Abelmann, W.H., Kowalski, H.J. and McNeely, W.F. (1955) The Hemodynamic Response to Exercise in Patients with Laennec’s Cirrhosis. Journal of Clinical Investigation, 34, 690-695.
http://dx.doi.org/10.1172/JCI103120
[7] Zuberi, B.F., Ahmed, S., Faisal, N., et al. (2007) Comparison of Heart Rate and QTc Duration in Patients of Cirrhosis of Liver with Non-Cirrhotic Controls. Journal of the College of Physicians and Surgeons Pakistan, 17, 69-71.
[8] Chugh, S.S., Reinier, K., Singh, T., et al. (2009) Determinants of prolonged QT Interval and Their Contribution to Sudden Death Risk in Coronary Artery Disease: The Oregon Sudden Unexpected Death Study. Circulation, 119, 663-670. http://dx.doi.org/10.1161/CIRCULATIONAHA.108.797035
[9] Bernardi, M., Calandra, S., Colantoni, A., et al. (1998) Q-T Interval Prolongation in Cirrhosis: Prevalence, Relationship with Severity, and Etiology of the Disease and Possible Pathogenetic Factors. Hepatology, 27, 28-34.
http://dx.doi.org/10.1002/hep.510270106
[10] Walsh, K. and Alexander, G.J. (2001) Update on Chronic Viral Hepatitis. Postgraduate Medical Journal, 77, 498-505.
http://dx.doi.org/10.1136/pmj.77.910.498
[11] Smedsrod, B., Pertoft, H., Gustafson, S., et al. (1990) Scavenger Functions of the Liver Endothelial Cell. Biochemical Journal, 266, 313-327.
[12] Ripoll, C., Catalina, M.V., Yotti, R., et al. (2008) Cardiac Dysfunction during Liver Transplantation: Incidence and Preoperative Predictors. Transplantation, 85, 1766-1772.
http://dx.doi.org/10.1097/TP.0b013e318172c936
[13] Alqahtani, S.A., Fouad, T.R. and Lee, S.S. (2008) Cirrhotic Cardiomyopathy. Seminars in Liver Disease, 28, 59-69.
http://dx.doi.org/10.1055/s-2008-1040321
[14] Jessup, M., Abraham, W.T., Casey, D.E., et al. (2009) 2009 Focused Update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration with the International Society for Heart and Lung Transplantation. Journal of the American College of Cardiology, 53, 1343-1382.
http://dx.doi.org/10.1016/j.jacc.2008.11.009
[15] Makkar, R.R., Fromm, B.S., Steinman, R.T., et al. (1993) Female Gender as a Risk Factor for Torsades de Pointes Associated with Cardiovascular Drugs. JAMA, 270, 2590-2597.
http://dx.doi.org/10.1001/jama.1993.03510210076031
[16] Li, L., Liu, H.R., Shu, J.L., et al. (2007) Clinical Investigation of Q-T Prolongation in Hepatic Cirrhosis. Zhonghua Yi Xue Za Zhi, 87, 2717-2718.
[17] Bal, J.S. and Thuluvath, P.J. (2003) Prolongation of QTc Interval: Relationship with Etiology and Severity of Liver Disease, Mortality and Liver Transplantation. Liver International, 23, 243-248.
http://dx.doi.org/10.1034/j.1600-0676.2003.00833.x
[18] Kosar, F., Ates, F., Sahin, I., et al. (2007) QT Interval Analysis in Patients with Chronic Liver Disease: A Prospective Study. Angiology, 58, 218-24. http://dx.doi.org/10.1177/0003319707300368

  
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