Related Experiment Video
Updated: Aug 13, 2026
Testing the Efficacy of Pharmacological Agents in a Pericardial Target Delivery Model in the Swine
Published on: July 7, 2016
Prognostic value of the QTc interval after cardiac transplantation
Bojan Vrtovec1, Rajko Radovancevic, Cynthia D Thomas
1Department of Cardiopulmonary Transplantation, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77225-0345, USA.
Insights
A significant increase in QTc interval duration after heart transplantation predicts mortality. Monitoring this change in heart transplant recipients can identify those at higher risk for adverse outcomes.
Area of Science:
- Cardiology
- Transplantation Medicine
- Electrophysiology
Background:
- QTc interval prolongation is a known risk factor for adverse outcomes in the general population.
- Its predictive value in heart transplant recipients remains unstudied.
- This study investigates QTc interval as a predictor of outcomes post-heart transplantation.
Purpose of the Study:
- To determine if a prolonged QTc interval predicts outcomes in heart transplant recipients.
- To assess the QTc interval's utility as a prognostic marker in this specific patient group.
Main Methods:
- 587 adult heart transplant recipients were analyzed.
- QTc intervals were measured using ECGs post-transplantation and annually.
- Follow-up averaged 85 months, with mortality data collected.
Main Results:
- A relative increase in QTc duration of >=10% between years 1 and 2 post-transplant (DeltaQTc >=10%) was associated with higher mortality.
- Patients with DeltaQTc >=10% had a 6.86-fold increased risk of death (p=0.0005).
- DeltaQTc >=10% was the sole independent predictor of long-term mortality in multivariate analysis (p=0.0008).
Conclusions:
- A relative QTc interval increase of >=10% between the first and second post-transplant year is a significant predictor of mortality.
- This finding highlights the importance of monitoring QTc interval changes in heart transplant recipients for risk stratification.
Background:
Although QTc interval prolongation is considered a risk factor for adverse outcome in the non-transplant population, its predictive value in heart transplant recipients has not been studied yet. This study was conducted to determine whether prolonged QTc interval is a useful predictor of outcome in heart transplant recipients.
Methods:
QTc intervals were measured in 587 adult patients who underwent heart transplantation between May 1982 and January 2002. QT interval duration was determined by averaging 3 consecutive beats in all 12 leads of the standard electrocardiogram (ECG) and corrected with the Bazett formula. Baseline ECGs were obtained within 7 days after transplantation; follow-up ECGs were recorded annually at the time of routine angiography. Patients were followed over 85 +/- 65 months (range, 3 months-17 years).
Results:
During follow-up, 241 patients died. The mean QTc interval duration in these patients was comparable with that in the remaining cohort (432 +/- 26 msec vs 423 +/- 25 msec, p = 0.07). However, patients with a relative increase in QTc duration of >or=10% between the first and second post-transplantation year (DeltaQTc >or= 10%) had a 6.86-times higher risk of dying compared with patients with DeltaQTc < 10% (p = 0.0005). Furthermore, DeltaQTc >or= 10% was the only independent predictor of long-term mortality on multivariate analysis (p = 0.0008).
Conclusions:
A relative increase in QTc interval duration of >or=10% between the first and second post-transplantation year is a strong, independent predictor of mortality in heart transplant recipients.
