Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Clin Cardiol. 2010 Nov;33(11):672-7. doi: 10.1002/clc.20801.
Studies have demonstrated that patients with end-stage liver disease (ESLD) often have a prolonged corrected QT interval (QTc) with variable changes in the QTc post-transplant. We sought to characterize the prevalence and degree of QTc prolongation in ESLD patients, identify risk factors for QTc prolongation, and assess changes in QTc following transplant.
QTc interval is prolonged in ESLD patients pre-transplant due to a variety of risk factors and shortens following liver transplantation.
We conducted a retrospective, multicenter study utilizing 2 large liver-transplant databases. QTc intervals were calculated utilizing Bazett's formula. The cutoff used for prolonged QTc was 440 milliseconds for men and 460 milliseconds for women.
There were 269 patients (169 men, 100 women) included in the final analysis. The mean pre-transplant QTc was prolonged (449.0 ms), whereas the mean post-transplant QTc shortened and was within normal limits (416.7 ms) (P < 0.0001). QTc shortened after transplant in 87% of patients. QTc normalized in 70% of patients. Age and Model for End-Stage Liver Disease (MELD) score were not predictive of prolonged QTc at baseline.
ESLD patients often have a prolonged QTc, which frequently shortens or normalizes after transplant. Screening for prolonged QTc is warranted if medications known to prolong the QTc interval are used in ESLD patients pre-transplant. MELD score, age, and sex were not predictive of prolonged QTc at baseline.
研究表明，终末期肝病（ESLD）患者常伴有校正 QT 间期（QTc）延长，且移植后 QTc 变化不定。我们旨在明确 ESLD 患者 QTc 延长的发生率和程度，确定 QTc 延长的危险因素，并评估移植后 QTc 的变化。
ESLD 患者由于多种危险因素，在移植前 QTc 延长，而在肝移植后 QTc 缩短。
我们进行了一项回顾性、多中心研究，利用了 2 个大型肝移植数据库。利用 Bazett 公式计算 QTc 间期。延长 QTc 的截点为男性 440 毫秒，女性 460 毫秒。
最终分析纳入了 269 例患者（169 例男性，100 例女性）。移植前平均 QTc 延长（449.0 ms），而移植后平均 QTc 缩短并在正常范围内（416.7 ms）（P < 0.0001）。87%的患者移植后 QTc 缩短。70%的患者 QTc 恢复正常。基线时，年龄和终末期肝病模型（MELD）评分均不能预测 QTc 延长。
ESLD 患者常伴有 QTc 延长，移植后常缩短或恢复正常。如果在移植前使用已知会延长 QTc 间期的药物，应筛查 QTc 延长。基线时，MELD 评分、年龄和性别均不能预测 QTc 延长。
