Pretransplant QT Interval: The Relationship with Severity and Etiology of Liver Disease and Prognostic Value After Liver Transplantation
Renata Główczyńska, Michalina Galas, Urszula Ołdakowska-Jedynak, Michał Peller, Mariusz Tomaniak, Joanna Raszeja-Wyszomirska, Piotr Milkiewicz, Marek Krawczyk, Krzysztof Zieniewicz, Grzegorz Opolski
1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
Ann Transplant 2018; 23:622-630
Prolonged QT interval is an integral part of the definition of cirrhotic cardiomyopathy. The aim of this study was to analyze the relationship between QT corrected (QTc) and the etiology and the severity of liver disease in relation to the complications of cirrhosis in candidates for orthotropic liver transplantation (OLTx).
MATERIAL AND METHODS: From 360 consecutive patients with end-stage liver disease (ESLD) consulted by a designated cardiologist, 160 patients underwent OLTx. The QTc was calculated according to 3 formulas in 151 ECG tracings with good quality. The severity of liver disease was assessed according to Child-Pugh classification and model for end-stage liver disease (MELD). This was a single-center study with register-based follow-up design.
RESULTS: Prolonged QTc over 440 ms was found in 51 subjects (33.8%), but none had prolonged QTc >500 ms. QTc corrected by Fridericia (F) formula was more suitable for patients with ESLD. We found no correlation between QTc interval and severity of liver disease. The QTc interval was higher in patients with alcoholic cirrhosis when compared to patients with viral hepatitis and ESLD of other etiologies. We observed a higher QTc interval in patients with gastroesophageal varices and encephalopathy. We did not notice any significant difference in the effect of the QTc interval on survival.
CONCLUSIONS: QTc interval might be associated with etiology and complication of ESLD. The prolonged QT interval is not associated with higher all-cause mortality after OLTx.
Keywords: Cardiomyopathies, Electrocardiography, End stage liver disease, Liver Transplantation, Mortality