Parameters of ventricular repolarization in patients with autoimmune hepatitis (original) (raw)
Related papers
2017
Electrophysiological abnormalities in cirrhosis, such as the prolongation of the QT interval, are associated with higher risk of ventricular arrhythmias. Holter monitoring offers a full picture of these during 24 hour. Our study aimed to evaluate the extent of the QT interval prolongation, identify etiological and biochemical elements linked with it, and investigate the correlation with ventricular arrhythmic events related to etiology and severity of liver cirrhosis. We included 43 patients with cirrhosis and evaluated the maximal QT interval (maxQT), corrected QT interval (QTc) and its maximum (maxQTc), and ventricular arrhythmic events during 24 hour Holter monitoring. All parameters were prolonged and significantly increased in alcoholic cirrhosis when compared to viral C or B etiology (P<0.05). MaxQT and QTc moderately correlated with serum proteins (r=0.402; P<0.01 and r=0.308; P<0.05) and triglycerides (r=-0.357; P<0.05 and r=-0.344; P<0.05). Viral C etiology a...
Indian Journal of Critical Care Medicine, 2020
Objectives: Impairment of cardiac function and arrhythmias often coexist in patients with liver diseases. Many studies have proved this coexistence and put forward various theories toward its pathophysiology. This narrative review tries to find the answers with supporting evidence on five main questions: • Do high serum bilirubin levels have a strong association with cardiac arrhythmias? • Can corrected QT interval (QTc) be relied upon for predicting a risk factor toward imminent arrhythmias? • Is there an association between QTc prolongation and mortality? • Are high serum bilirubin and cardiac dysfunction closely associated? • What is the probable pathophysiology behind this association? Materials and methods: Clinical evidence was obtained by using search engines, namely, Cochrane Library, PubMed, and Google Scholar. Studies published in journals in the English language, between January 1969 and December 2019, which mentioned the relationship between cardiac arrhythmia and liver disease, were included. We used the keywords: jaundice, bilirubin, arrhythmia, ECG, QTc interval, QT dispersion, liver, and cirrhosis. Relevant animal or human studies answering the five main questions were extracted and reviewed. Conclusion: The evidence included in our review sheds light on the fact that approximately 50% of liver cirrhosis cases develop cirrhotic cardiomyopathy (CC) and there has been an association between liver abnormalities and cardiac pathology. The present review also supports that there exists a strong association between high levels of serum bilirubin levels and cardiac arrhythmias, QTc value can be relied upon as a risk factor for predicting imminent arrhythmias, and that it is associated with mortality. Its basic pathophysiology can be explained by the potential action of bile acids in prolonging the QT interval. It also causes cardiac hypertrophy and apoptosis of cardiomyocytes leading to cardiac dysfunction.
Prolongation of the QTc interval in patients with cirrhosis
ANNALS OF GASTROENTEROLOGY, 2003
QT interval prolongation predicts severe ventricular arrhythmias and sudden death. The aim of this work was to confirm the prevalence of QT interval prolongation in patients with liver cirrhosis due to alcoholism and chronic hepatitis B or C and define its association with the severity of the disease. Fifty-two patients with cirrhosis (29 due to alcohol abuse and 23 due to chronic hepatitis B or C) were enrolled. In all patients QT interval corrected (QTc) for ventricular heart rate was assessed along with Child-Pugh score. QTc was found prolonged in both groups of patients with alcoholic and postviral cirrhosis (0,471 sec, P=0,0007 and 0,461 sec, P=0,0017 respectively) with no difference between the two groups (P=0,3142). Prolongation of the QTc interval was statistically confirmed in Child-Pugh C and B groups (0,489 sec, P=0,0019 and 0,480 sec, P=0,0002 respectively) but not in Child-Pugh A group (0,445 sec, P=0,4366). These data show that QTc interval prolongation in cirrhotic patients refers to Child-Pugh B and C but is independent from the etiology of cirrhosis.
Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2007
To compare QTc duration and Heart Rate (HR) in patients with cirrhosis with non-cirrhotic controls. Cross-sectional analytical study. Civil Hospital and Lyari General Hospital, Karachi, from March 2004 to February 2006. Confirmed patients of cirrhosis were selected and allocated to Group-I. An equal number of non-cirrhotic patients were taken as control and were allocated to Group-II. ECG was recorded and values of HR and QTc were calculated. Comparison of increased frequency of HR and prolongation of QTc were done using Chi-square test or Fisher's Exact Test with significance level at <or= 0.05. ROC curves of HR and QTc were plotted for the presence of cirrhosis. Seventy-eight confirmed patients of cirrhosis of liver were inducted in Group-I with same number of non-cirrhotic patients as control in Group-II. The mean +/- SD of QTc of Group-I was 0.438 +/- 0.015 sec and that in Group-II was 0.432 +/- 0.010 sec and that for HR in Group-I and II were 78.34 +/- 12.15 and 74.98+/-...
Clinical Science, 2009
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 ...
Q-T Interval Prolongation in Patients with Liver Cirrhosis
Current Health Sciences Journal, 2018
Liver cirrhosis (LC) is the end stage of chronic liver disease characterized by the appearance of extensive fibrosis and regeneration nodes associated with hepatocyte necrosis in liver but also by the reshuffling of hepatic architecture. The triad consisting of hepatic parenchymal necrosis, regeneration and scarring is always present regardless of the type of clinical manifestation. The Child-Pugh-Turcotte classification dates back more than 30 years and has been widely used in diagnosing and assessing the severity of liver cirrhosis. This is preferred due to a low degree of complexity and a good predictive value. Prolongation of the QT interval on the electrocardiogram is common, with a prevalence exceeding 60% in patients with advanced stage of cirrhosis. In these cases, beta blockers and antiarrhythmics should be avoided or used with caution and with close QT interval monitoring. Changes in heart rate and Q-T interval are new entities in cirrhosis complications. A prolonged Q-T i...
Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, 2016
Arrhythmias and electrocardiographic changes are reported in several noncardiac diseases, including liver cirrhosis (LC). We intended to evaluate the interval from the peak to the end of the electrocardiographic T wave (Tp-e), Tp-e/QTc ratio, and fQRS as presumed markers of arrhythmias in LC. In this cross-sectional study, a total of 88 consecutive patients with LC according to clinical, biological, ultrasonographic, or histological criteria and 73 control subjects were enrolled. The severity of cirrhosis was classified according to Pugh-Child's classification and Model for End-Stage Liver Disease (MELD) score. Tp-e interval, Tp-e/QTc ratio, and fQRS rates were measured from the 12-lead electrocardiogram. Tp-e interval, Tp-e/QTc ratio and fQRS rates were significantly increased in parallel to the severity of LC (P < 0.001, P < 0.001, and P = 0.003, respectively). In correlation analysis, Pugh-Child stage showed a significantly positive correlation with Tp-e interval (r = 0...
Translational Pediatrics, 2021
Background: The cardiovascular system is directly influenced by the autonomic nervous system (ANS); its changes affect heart rate variability (HRV) and are sensitive indicators of physiological changes. Autonomic dysfunction (AD) is manifested in up to 60% of patients with cirrhosis. Therefore, we aim to analyze the indexes of HRV pre-and post-surgery of children submitted for liver transplantation (LT). Methods: HRV, in children of both genders from 6 months of age to 10 years, that attended at the pediatric surgery clinic in the queue for LT at the Children's Institute were analyzed. To access HRV we analyzed indexes such as standard deviation of the RR intervals (SDNN), root-mean-square of the successive normal sinus RR interval difference (RMSSD), low frequency (LF), high frequency (HF), and LF/HF. Results: The analysis of the behavior of cardiac autonomic modulation, in the period prior to LT and after surgery, showed an increase in HRV linear parameters SDNN, TINN (triangular interpolation of NN interval histogram), HFms 2. In the time domain, there was also an increase in the HFms 2 index. Conclusions: The analysis of the period preceding LT and two months after surgery showed an increase in the HRV linear parameters representing a global HRV improvement. In the time domain, there was also an increase in the HFms 2 index, parasympathetic tone of the HRV.