Related Experiment Video

Updated: Jul 29, 2026

Determining the Likelihood of Variant Pathogenicity Using Amino Acid-level Signal-to-Noise Analysis of Genetic Variation
07:15

Determining the Likelihood of Variant Pathogenicity Using Amino Acid-level Signal-to-Noise Analysis of Genetic Variation

Published on: January 16, 2019

Prolongation of the QT interval in children with liver failure

S B Fishberger1, N S Pittman, A F Rossi

  • 1Division of Pediatric Cardiology, Mount Sinai Medical Center, New York, New York, USA.

Clinical Cardiology
|October 20, 1999
PubMed

Insights

Pediatric hepatic failure can cause QT prolongation, a heart rhythm abnormality. This condition appears reversible after successful liver transplantation in children.

Area of Science:

  • Pediatric Cardiology
  • Hepatology
  • Electrophysiology

Background:

  • Alcoholic liver disease is linked to QT prolongation and sudden cardiac death.
  • Hepatic failure may cause cardiac repolarization abnormalities in children.

Purpose of the Study:

  • To evaluate ventricular repolarization abnormalities in pediatric patients with hepatic failure.
  • To determine the incidence and reversibility of QT prolongation in children awaiting liver transplantation.

Main Methods:

  • A cohort of 38 pediatric patients (mean age 6.5 years) underwent ECG and echocardiogram evaluation for liver transplantation.
  • Patients had normal electrolytes and were not on repolarization-prolonging medications.
  • Follow-up ECGs were performed on survivors post-liver transplantation.

Main Results:

  • 18% (7/38) of patients exhibited prolonged corrected QT interval (QTc > 450 ms).
  • No significant differences in liver function indices were observed between patients with normal and prolonged QTc.
  • Four survivors showed QTc normalization after liver transplantation; two patients died pre-transplant and one post-transplant.

Conclusions:

  • QTc prolongation is a notable finding in children with hepatic failure.
  • The mechanism of QTc prolongation in hepatic failure remains unclear.
  • QTc prolongation appears to be reversible following successful liver transplantation.
Abstract

More Related Videos

Electrocardiogram Recordings in Anesthetized Mice using Lead II04:16

Electrocardiogram Recordings in Anesthetized Mice using Lead II

Published on: June 20, 2020

Implementation of Non-invasive Point of Care Transient Elastography for Evaluation of Liver Disease in Pediatric Populations with Cystic Fibrosis05:56

Implementation of Non-invasive Point of Care Transient Elastography for Evaluation of Liver Disease in Pediatric Populations with Cystic Fibrosis

Published on: August 29, 2025

Related Concept Videos

Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers01:12

Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers

Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of the heart's...
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow01:26

Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow

Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug binding...
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test01:22

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...
Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment01:08

Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment

Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...