Prevalence of Prolonged QT Interval In Patients With Chronic Liver Disease
Prolonged Qt Interval in Patients with Chronic Liver Disease
DOI:
https://doi.org/10.54393/pjhs.v3i05.258Keywords:
QT interval prolongation, Cirrhotic cardiomyopathy, Liver cirrhosis.Abstract
The incidence of QT prolongation in CLD patients is greater than 45% compared to approximately 5% in the general population. Multiple researches have revealed that end-stage liver disease is related with a variety of changes in electrophysiological parameters; especially in our population, a higher incidence of QT interval prolongation is observed. Prolonged QT intervals in chronic liver disease patients are related with augmented mortality and morbidity. Objective: To determine the frequency of QT prolongation in patients with chronic liver disease. Methods: A cross-sectional and descriptive study. 96 total patients aged 20-85 years of both sexes with chronic liver disease (CLD) were included. Patients with a history of coronary artery disease and the use of any anti-arrhythmic medication were excluded from the study. The 12-lead ECG was performed and interpreted by an electrophysiologist with over five years of experience. The Bazett-based QT interval (QTc) was automatically obtained using a computerized electrocardiograph to avoid inter-observer variability. Results: 20 to 60 years was the patients age in this study, with 39.44 ± 9.91 years of mean age. The maximum patients, 86 (89.58%), were 20-40 years of age. Among the 96 patients, 17 (17.71%) were female and 79 (82.17%) were male, with a M: F ratio of 1.3: 1. While the incidence of QT prolongation was found in 47 (48.96%) patients, 49 (51.04%) patients did not have QT prolongation. Conclusions: In this study it was found that the frequency of QT prolongation is quite high in patients with chronic liver disease
References
Rimbaş RC, Baldea SM, Guerra RDGA, Visoiu SI, Rimbaş M, Pop CS, et al. New Definition Criteria of Myocardial Dysfunction in Patients with Liver Cirrhosis: A Speckle Tracking and Tissue Doppler Imaging Study. Ultrasound in Medicine and Biology. 2018 Mar; 44(3):562-574. doi: 10.1016/j.ultrasmedbio.2017.11.013.
Voiosu AM, Daha IC, Voiosu TA, Mateescu BR, Dan GA, Băicuş CR, et al. Prevalence and impact on survival of hepatopulmonary syndrome and cirrhotic cardiomyopathy in a cohort of cirrhotic patients. International journal of hepatology. 2015 Dec; 35(12):2547-55. doi: 10.1111/liv.12866.
Zardi EM, Abbate A, Zardi DM, Dobrina A, Margiotta D, Van Tassell BW, et al. Cirrhotic cardiomyopathy. American College of Cardiology. 2010 Aug; 56(7):539-49. doi: 10.1016/j.jacc.2009.12.075.
Hammami R, Boudabbous M, Jdidi J, Trabelsi F, Mroua F, Kallel R, et al. Cirrhotic cardiomyopathy: is there any correlation between the stage of cardiac impairment and the severity of liver disease? Libyan Journal of Medicine. 2017 Dec; 12(1):1283162. doi: 10.1080/19932820.2017.1283162.
Nagueh SF, Smiseth OA, Appleton CP, Byrd BF 3rd, Dokainish H, Edvardsen T, et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Journal of the American Society of Echocardiography. 2016 Apr; 29(4):277-314. doi: 10.1016/j.echo.2016.01.011.
Kosar F, Ates F, Sahin I, Karincaoglu M, Yildirim B. QT interval analysis in patients with chronic liver disease: a prospective study. Angiology. 2007 May; 58(2):218-24. doi: 10.1177/0003319707300368.
Kim SM, George B, Alcivar-Franco D, Campbell CL, Charnigo R, Delisle B, et al. QT prolongation is associated with increased mortality in end stage liver disease. World Journal of Cardiology. 2017 Apr; 9(4):347.
Schooling CM, Zhao J, Zhang Y. The association of androgens with QT interval and heart rate in US men. International Journal of Cardiology. 2014 Dec; 177(2):592-4. doi: 10.1016/j.ijcard.2014.08.146.
Detta N, Frisso G, Zullo A, Sarubbi B, Cozzolino C, Romeo E, et al. Novel deletion mutation in the cardiac sodium channel inactivation gate causes long QT syndrome. International journal of cardiology. 2013 May; 165(2):362-5. doi: 10.1016/j.ijcard.2012.08.032.
Tarapués M, Cereza G, Arellano AL, Montané E, Figueras A. Serious QT interval prolongation with ranolazine and amiodarone. International journal of cardiology. 2014 Mar; 172(1):e60-1. doi: 10.1016/j.ijcard.2013.12.061.
Bal JS and Thuluvath PJ. Prolongation of QTc interval: relationship with etiology and severity of liver disease, mortality and liver transplantation. Liver International. 2003 Aug; 23(4):243-8. doi: 10.1034/j.1600-0676.2003.00833. x.
Wong F. Cirrhotic cardiomyopathy. International journal of hepatology. 2009 Mar; 3(1):294-304. doi: 10.1007/s12072-008-9109-7.
Negru RD, Cojocaru DC, Felea M, Trifan A. QT interval parameters and ventricular arrhythmic events in liver cirrhosis correlation with severity and etiology. Biomedical Research. 2017 Jun; 28(3):1130-4.
Marafioti V, Benetti V, Montin U, Carbone V, Petrosino A, Tedeschi U, et al. QTc interval prolongation and hepatic encephalopathy in patient’s candidates for liver transplantation: A valid inference? International Journal of Cardiology. 2015 Jun; 188:43-4. doi: 10.1016/j.ijcard.2015.04.026.
Møller S, Hove JD, Dixen U, Bendtsen F. New insights into cirrhotic cardiomyopathy. International Journal of Cardiology. 2013 Aug; 167(4):1101-8. doi: 10.1016/j.ijcard.2012.09.089.
Josefsson A, Fu M, Björnsson E, Kalaitzakis E. Prevalence of pre-transplant electrocardiographic abnormalities and post-transplant cardiac events in patients with liver cirrhosis. BMC Gastroenterology. 2014 Apr; 14:65. doi: 10.1186/1471-230X-14-65.
Ali M. Frequency of corrected qt interval in patients with cirrhosis. Journal of Rawalpindi Medical College. 2016 Jun; 20(2):79-91.
Bazett HC. An Analysis of the Time-Relations of. Heart. 1920; 7:353.
Rodríguez-Roisin R, Krowka MJ, Hervé P, Fallon MB; ERS Task Force Pulmonary-Hepatic Vascular Disorders (PHD) Scientific Committee. Pulmonary-Hepatic Vascular Disorders (PHD). European clinical respiratory journal. 2004 Nov; 24(5):861-80. doi: 10.1183/09031936.04.00010904.
Kim MY, Choi H, Baik SK, Yea CJ, Won CS, Byun JW, et al. Portal hypertensive gastropathy: correlation with portal hypertension and prognosis in cirrhosis. Journal of digestive diseases. 2010 Dec; 55(12):3561-7. doi: 10.1007/s10620-010-1221-6.
Tangerman A, Meuwese-Arends MT, Jansen JB. Cause and composition of foetor hepaticus. Lancet. 1994 Feb; 343(8895):483. doi: 10.1016/s0140-6736(94)92729-4.
Fitzpatrick TB, Johnson RA, Wolff K, Polano MK, Suurmond D. Color atlas ans synopsis of clinical dermatology: common and serious diseases. InColor atlas ans synopsis of clinical dermatology: common and serious diseases 1997.
Halfon P, Munteanu M, Poynard T. FibroTest-ActiTest as a non-invasive marker of liver fibrosis. Clinical journal of gastroenterology. 2008 Sep; 32(6):1.22-39. doi: 10.1016/S0399-8320(08)73991-5.
Okazaki H, Ito K, Fujita T, Koike S, Takano K, Matsunaga N. Discrimination of alcoholic from virus-induced cirrhosis on MR imaging. AJR. American journal of roentgenology. 2000 Dec; 175(6):1677-81. doi: 10.2214/ajr.175.6.1751677.
Harbin WP, Robert NJ, Ferrucci JT Jr. Diagnosis of cirrhosis based on regional changes in hepatic morphology: a radiological and pathological analysis. Radiology. 1980 May; 135(2):273-83. doi: 10.1148/radiology.135.2.7367613
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Pakistan Journal of Health Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments