| QT interval prolongation and decreased heart rate variability in cirrhotic patients: relevance of hepatic venous pressure gradient and serum calcium. | |
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MedLine Citation:
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PMID: 19076059 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A prolongation of QT interval has been shown in patients with cirrhosis and it is considered as part of the definition of the so-called 'cirrhotic cardiomyopathy'. The aim of the present study was to assess the determinants of QT interval prolongation in cirrhotic patients. Forty-eight male patients with different stages of liver disease were divided into three subgroups according to the Child-Pugh classification. All patients underwent a 24-h ECG Holter recording. The 24-h mean of QT intervals corrected for heart rate (termed QTc) and the slope of the regression line QT/RR were calculated. HRV (heart rate variability), plasma calcium and potassium concentration and HVPG (hepatic venous pressure gradient) were measured. QTc was progressively prolonged from Child A to Child C patients (P=0.001). A significant correlation between QTc and HVPG was found (P=0.003). Patients with alcohol-related cirrhosis presented QTc prolongation more frequently than patients with post-viral cirrhosis (P<0.001). The QT/RR slope was steeper in subjects with alcoholic aetiology as compared with viral aetiology (P=0.02), suggesting that these patients have a further QTc prolongation when heart rate decreases. The plasma calcium concentration was inversely correlated with QTc (P<0.001). The presence of severe portal hypertension was associated with decreased HRV (P<0.001). Cirrhotic patients with a more severe disease, especially of alcoholic aetiology, who have greater HVPG and lower calcium plasma levels, have an altered ventricular repolarization and a reduced vagal activity to the heart, which may predispose to life-threatening arrhythmias. |
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Authors:
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Simonetta Genovesi; Daniela M Prata Pizzala; Massimo Pozzi; Laura Ratti; Maria Milanese; Federico Pieruzzi; Antonio Vincenti; Andrea Stella; Giuseppe Mancia; Marco Stramba-Badiale |
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Publication Detail:
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Type: Journal Article Date: 2009-05-14 |
Journal Detail:
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Title: Clinical science (London, England : 1979) Volume: 116 ISSN: 1470-8736 ISO Abbreviation: Clin. Sci. Publication Date: 2009 Jun |
Date Detail:
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Created Date: 2009-05-11 Completed Date: 2009-08-03 Revised Date: 2011-05-25 |
Medline Journal Info:
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Nlm Unique ID: 7905731 Medline TA: Clin Sci (Lond) Country: England |
Other Details:
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Languages: eng Pagination: 851-9 Citation Subset: IM |
Affiliation:
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Department of Clinical Medicine and Prevention, University of Milano-Bicocca, via Cadore 48, Monza 20052, Italy. simonetta.genovesi@unimib.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Analysis of Variance Calcium / metabolism Cardiomyopathies / ultrasonography Echocardiography Electrocardiography, Ambulatory Humans Liver Cirrhosis / blood, complications*, physiopathology Long QT Syndrome / blood, etiology*, physiopathology Male Middle Aged Portal Pressure / physiology |
| Chemical | |
Reg. No./Substance:
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7440-70-2/Calcium |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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