Department of Medicine, Heart, Stroke and Vascular Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Medicine, Dongtan Sacred Heart Hospital, Hallym University School of Medicine, Seoul, Republic of Korea.
PLoS One. 2018 Oct 26;13(10):e0206463. doi: 10.1371/journal.pone.0206463. eCollection 2018.
Prolongation of corrected QT interval (QTc) on the electrocardiogram is associated with cardiac arrhythmia and sudden death. Changes in the QTc (corrected QT) interval before and after liver transplantation (LT) for the treatment of liver cirrhosis (LC) and its association with clinical outcomes have not been fully evaluated.
From January 2011 to May 2016, consecutive 516 consecutive recipients were enrolled into LT registry and the median follow-up was 31 months (IQR 12-52). Patients with an available electrocardiogram before LT and 1 month after from LT were analyzed. Patients were divided into 2 groups according to prolonged QTc interval. The patient groups were analyzed separately according whether the electrocardiogram was preoperative or postoperative. The primary outcome was all-cause death during the follow-up period.
A total of 283 patients were enrolled in the study. In the preoperative QTc prolongation group, there was not a significant rate difference in all-cause mortality in multivariate analysis (hazard ratio [HR], 0.94; 95% confidence interval [CI], 0.53-1.66; P = 0.26). However, in the postoperative QTc prolongation group, mortality was significantly increased (HR, 1.78; 95%CI, 1.05-3.03; P = 0.03) in patients who underwent LT.
In patients who underwent LT for LC, postoperative QTc prolongation on ECG, rather than preoperative, is associated with mortality. Larger clinical trials are needed to support this finding.
心电图上校正 QT 间期（QTc）的延长与心律失常和心脏性猝死有关。肝硬化（LC）患者行肝移植（LT）治疗前后 QTc（校正 QT）间期的变化及其与临床结局的关系尚未得到充分评估。
从 2011 年 1 月至 2016 年 5 月，连续纳入 516 例连续接受 LT 的患者，并进行了中位 31 个月（IQR 12-52）的随访。分析了 LT 前和 LT 后 1 个月有可用心电图的患者。根据延长的 QTc 间隔将患者分为 2 组。根据心电图是术前还是术后，对患者组进行了单独分析。主要终点是随访期间的全因死亡。
共纳入 283 例患者。在校正 QTc 延长的术前组中，多变量分析显示全因死亡率无显著差异（危险比 [HR]，0.94；95%置信区间 [CI]，0.53-1.66；P=0.26）。然而，在校正 QTc 延长的术后组中，LT 术后死亡率显著增加（HR，1.78；95%CI，1.05-3.03；P=0.03）。
在因 LC 而行 LT 的患者中，ECG 上的术后 QTc 延长与死亡率相关，而不是术前。需要更大的临床试验来支持这一发现。
