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肝硬化患者的QTc延长及其与疾病严重程度的关系:来自一家乡村教学医院的观察性研究。

QTc prolongation in patients of cirrhosis and its relation with disease severity: An observational study from a rural teaching hospital.

作者信息

Bhardwaj Abhinav, Joshi Sandeep, Sharma Ruby, Bhardwaj Sakshi, Agrawal Rishabh, Gupta Nitin

机构信息

Department of Medicine, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India.

Department of Physiology, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India.

出版信息

J Family Med Prim Care. 2020 Jun 30;9(6):3020-3024. doi: 10.4103/jfmpc.jfmpc_341_20. eCollection 2020 Jun.

Abstract

INTRODUCTION

Cirrhotic cardiomyopathy is characterised by increased baseline cardiac output, systolic and diastolic dysfunction, diminished cardiovascular response to stressful stimuli and electrophysiological abnormalities in patients of cirrhosis in the absence of any underlying cardiac disease. QTc prolongation has been described as a common electrocardiographic abnormality in cirrhosis patients.

AIMS AND OBJECTIVES

This study was done to evaluate the prevalence of QTc changes in patients of cirrhosis coming to a rural tertiary care centre and to analyse its correlation with disease severity.

MATERIALS AND METHODS

The present study was conducted on 100 patients suffering from cirrhosis of liver presented to the department of medicine. Around 100 age and sex-matched individuals were recruited as controls. The Child-Pugh score was used to determine the disease severity in cirrhosis patients. Standard 12-lead ECG was recorded in all cases and controls.

RESULTS

Prolongation of QTc interval on ECG was observed in the majority (80%) of cirrhosis patients and it was significantly higher as compared to the healthy controls ( <0.01). The prolongation of QTc was significantly associated with the duration of disease ( <0.05) and disease severity as measured by the Child-Pugh score ( <0.01).

CONCLUSION

QTc prolongation on ECG may be an early marker of cardiac involvement in patients of cirrhosis and is significantly associated with disease severity.

摘要

引言

肝硬化性心肌病的特征是在没有任何潜在心脏疾病的肝硬化患者中,基线心输出量增加、收缩和舒张功能障碍、对压力刺激的心血管反应减弱以及电生理异常。QTc延长已被描述为肝硬化患者常见的心电图异常。

目的

本研究旨在评估前来农村三级医疗中心就诊的肝硬化患者中QTc变化的患病率,并分析其与疾病严重程度的相关性。

材料与方法

本研究对100例肝病科收治的肝硬化患者进行。招募了约100名年龄和性别匹配的个体作为对照。采用Child-Pugh评分来确定肝硬化患者的疾病严重程度。对所有病例和对照记录标准12导联心电图。

结果

大多数(80%)肝硬化患者的心电图显示QTc间期延长,与健康对照相比显著更高(<0.01)。QTc延长与疾病持续时间(<0.05)以及通过Child-Pugh评分衡量的疾病严重程度显著相关(<0.01)。

结论

心电图上的QTc延长可能是肝硬化患者心脏受累的早期标志物,并且与疾病严重程度显著相关。

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本文引用的文献

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Association of Cirrhosis and Cardiomyopathy.肝硬化与心肌病的关联
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Cardiac Dysfunction in Patients with Liver Cirrhosis.肝硬化患者的心脏功能障碍
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