Association of QTc prolongation with liver function test and complications in patients with cirrhosis: An
Rhythm Yogandh Relekar1, Priyavardhan Mishra1, Vishal Raghunath Gabale2
1DY Patil Deemed to be University School of Medicine, Navi Mumbai, Maharashtra, India.
Insights
QTc prolongation is a common ECG abnormality in liver cirrhosis patients, affecting over 64%. This cardiac issue correlates significantly with liver function tests and common cirrhotic complications.
Area of Science:
- Cardiology
- Hepatology
- Clinical Medicine
Background:
- Cirrhotic cardiomyopathy is a cardiac dysfunction linked to hepatic cirrhosis.
- Electrocardiographic (ECG) abnormalities are common, often without overt symptoms.
- Understanding these ECG changes is crucial for patient management.
Purpose of the Study:
- To investigate ECG changes, specifically QTc interval, in patients with diverse causes of liver cirrhosis.
- To correlate these ECG findings with liver function tests (LFTs) and clinical complications of cirrhosis.
Main Methods:
- A study involving 300 patients with various etiologies of liver cirrhosis (e.g., ALD, NASH, DCLD, AIH, HCC, Hep-B, Wilson's disease).
- Assessment of QTc interval and correlation with LFT parameters (SGOT, SGPT, ALP, indirect bilirubin).
- Correlation of QTc interval with cirrhosis complications like portal hypertension, splenomegaly, and ascites, and Child-Pugh class.
Main Results:
- Prolonged QTc interval was detected in 194 (64.66%) patients, most frequently in DCLD.
- Significant associations were found between prolonged QTc and complications (portal hypertension, splenomegaly, ascites) (P < 0.001).
- QTc interval showed significant correlation with Child-Pugh class and SGOT/SGPT levels (P < 0.001), but not with ALP or indirect bilirubin.
Conclusions:
- Prolonged QTc interval is a prevalent ECG abnormality in liver cirrhosis.
- QT prolongation is significantly correlated with elevated liver enzymes and the presence of cirrhotic complications.
Introduction:
Cirrhotic cardiomyopathy is a cardiac abnormality due to hepatic cirrhosis, which presents as a serious electrocardiographic complication and often the patient is asymptomatic. The objective of our study was to find the ECG changes in patients with various aetiologies of cirrhosis and correlate them with their respective LFT parameters.
Materials And Methodology:
We assessed the QTc interval in patients of various aetiologies of liver cirrhosis and correlated them with the prevalence of complication of cirrhosis, such as portal hypertension, splenomegaly, and ascites. Furthermore, we correlated the LFT parameters with their respective QTc interval.
Results:
Our study evaluated 300 patients of multiple aetiologies of cirrhosis, such as ALD, NASH, DCLD, AIH, HCC, HA, Hep-B, and Wilson's disease. Prolonged QTc was observed in 194 (64.66%) patients. QTc prolongation was most prevalent in DCLD patients. The association of complication including portal hypertension, splenomegaly, and ascites with prolonged QTc were all statistically significant (P = <0.001). QTc ms was significantly related to the Child-Pugh class (P = <0.001). SGOT and SGPT parameters were significantly correlated with QTc intervals (P = <0.001) in all aetiologies of liver disease. However, the correlation between ALP and indirect bilirubin levels with QTc interval was not statistically significant.
Conclusion:
Prolonged QTc interval is frequently observed as the ECG abnormality in patients with cirrhosis. QT prolongation correlates with elevated LFTs and cirrhotic complications.
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