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. © The Authors.
Genovesi, S.C., Prata Pizzala, D.M., Pozzi, M., Ratti, L., Milanese, M., Pieruzzi, F., et al. (2009). QT interval prolongation and decreased heart rate variability in cirrhotic patients: relevance of hepatic venous pressure gradient and serum calcium. CLINICAL SCIENCE, 116, 851-859.
Citazione: | Genovesi, S.C., Prata Pizzala, D.M., Pozzi, M., Ratti, L., Milanese, M., Pieruzzi, F., et al. (2009). QT interval prolongation and decreased heart rate variability in cirrhotic patients: relevance of hepatic venous pressure gradient and serum calcium. CLINICAL SCIENCE, 116, 851-859. |
Tipo: | Articolo in rivista - Articolo scientifico |
Carattere della pubblicazione: | Scientifica |
Titolo: | QT interval prolongation and decreased heart rate variability in cirrhotic patients: relevance of hepatic venous pressure gradient and serum calcium |
Autori: | Genovesi, SC; Prata Pizzala, DM; Pozzi, M; Ratti, L; Milanese, M; Pieruzzi, FUEG; Vincenti, A; Stella, A; Mancia, G; Stramba-Badiale, M |
Autori: | |
Data di pubblicazione: | 2009 |
Lingua: | English |
Rivista: | CLINICAL SCIENCE |
Digital Object Identifier (DOI): | http://dx.doi.org/10.1042/CS20080325 |
Appare nelle tipologie: | 01 - Articolo su rivista |