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Diastolic Dysfunction, Prolonged QTc interval and Pericardial effusion as Predictors of Mortality in Acute Pancreatitis.
MedLine Citation:
PMID:  22849657     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background:  The cardiac changes in acute pancreatitis have been earlier studied but the data on their prognostic significance is limited. This study was done to determine electrocardiographic (ECG) & echocardiographic changes in acute pancreatitis & determine their prognostic significance. Patients & Methods:  Fifty-two consecutive patients (mean age 36.5 ± 11 yrs (44 males) with acute pancreatitis & without prior cardiovascular comorbidites were prospectively enrolled and subjected to clinical, laboratory and radiological investigation. ECG and echocardiography was done at admission and during follow up. Results:  17 patients (32.7%) had mild pancreatitis and 35 (67.3%) patients had severe pancreatitis. Sinus tachycardia was most common ECG abnormality. QTc prolongation was seen in 30/52 (57.7%) patients. On echocardiography, no patient had systolic dysfunction but 31/52 (59.6%) patients had diastolic dysfunction. All 22 patients with QTc interval < 440 msec survived compared to 8/30 patients with QTc interval ≥ 440 msec who died (p=0.01). All 8 patients who died had evidence of diastolic dysfunction (100%). None of the patients without diastolic dysfunction succumbed to illness (p=0.02). Pericardial effusion was present in 6/52 (11.5%) patients. Of the 8 patients who died, pericardial effusion was present in 3 (37.5%) patients and this frequency was significantly higher than that in patients who recovered (3/44 (6.8%); p=0.04) Conclusion:  ECG & echocardiographic changes are seen in more than 50% of patients with acute pancreatitis. Prolonged QTc interval, pericardial effusion and diastolic dysfunction are associated with higher mortality. © 2012 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.
Authors:
Nikhil Nadkarni; Deepak Kumar Bhasin; Surinder Singh Rana; Ajay Bahl; Saroj Kant Sinha; Chalapathi Rao; Kewal Kishan Talwar
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-31
Journal Detail:
Title:  Journal of gastroenterology and hepatology     Volume:  -     ISSN:  1440-1746     ISO Abbreviation:  J. Gastroenterol. Hepatol.     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-8-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607909     Medline TA:  J Gastroenterol Hepatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.
Affiliation:
Department of Gastroenterology, Cardiology, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh -160012, India.
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