Department of Gastroenterology, University of Gaziantep, Gaziantep, Turkey.
Eur Rev Med Pharmacol Sci. 2023 Feb;27(3):1110-1120. doi: 10.26355/eurrev_202302_31214.
The cardiovascular system is one of the most affected systems in the liver cirrhosis (LC) process, especially due to the tendency to arrhythmia. Since the data about the relationship between LC and novel electrocardiography (ECG) indexes are lacking, we aimed to investigate the association between LC and Tp-e interval, Tp-e/QT, and Tp-e/QTc ratio.
The study included 100 patients in the study group (56 male, median age 60) and 100 in the control group (52 female, 60 median age) between January 2021 and January 2022. ECG indexes and laboratory findings were analyzed.
The patient group had significantly higher heart rate (HR), Tp-e, Tp-e/QT, and Tp-e/QTc compared to the control group (p < 0.001 for all). There was no difference in terms of QT, QTc, QRS (depolarization of ventricles, involving Q, R, and S waves on ECG) duration, and ejection fraction between the two groups. Kruskal-Wallis test results revealed that there was a significant difference between Child stages in terms of HR, QT, QTc, Tp-e, Tp-e/QT, Tp-e/QTc, and QRS duration. There was also a significant difference between the model for end-stage liver disease (MELD) score groups in terms of all these parameters except for Tp-e/QTc. In the ROC analyses of Tp-e, Tp-e/QT and Tp-e/QTc to predict the Child C, the AUC values were 0.887; (95% CI: 0.853-0.921), 0.730; (95% CI: 0.680-0.780), and 0.670; (95% CI: 0.614-0.726), respectively. Similarly, AUC values for the MELD score > 20 were 0.877; (95% CI: 0.854-0.900), 0.935; (95% CI: 0.918-0.952), and 0.861; (95% CI: 0.835-0.887); (p < 0.001 for all).
Tp-e, Tp-e/QT, and Tp-e/QTc values were significantly higher in patients with LC. These indexes can be useful for arrhythmia risk stratification and to predict the end-stage of the disease.
心血管系统是肝硬化（LC）过程中受影响最严重的系统之一，尤其是心律失常的倾向。由于缺乏关于 LC 与新型心电图（ECG）指标之间关系的数据，我们旨在研究 LC 与 Tp-e 间期、Tp-e/QT 和 Tp-e/QTc 比值之间的关系。
本研究纳入了 2021 年 1 月至 2022 年 1 月期间的 100 例研究组患者（56 名男性，中位年龄 60 岁）和 100 例对照组患者（52 名女性，中位年龄 60 岁）。分析了心电图指标和实验室检查结果。
与对照组相比，患者组的心率（HR）、Tp-e、Tp-e/QT 和 Tp-e/QTc 明显更高（所有 p<0.001）。两组之间的 QT、QTc、QRS（心室除极，包括 ECG 上的 Q、R 和 S 波）持续时间和射血分数没有差异。Kruskal-Wallis 检验结果表明，HR、QT、QTc、Tp-e、Tp-e/QT、Tp-e/QTc 和 QRS 持续时间在 Child 分期之间存在显著差异。MELD 评分组之间在除 Tp-e/QTc 之外的所有参数方面也存在显著差异。在 Tp-e、Tp-e/QT 和 Tp-e/QTc 预测 Child C 的 ROC 分析中，AUC 值分别为 0.887（95%CI：0.853-0.921）、0.730（95%CI：0.680-0.780）和 0.670（95%CI：0.614-0.726）。同样，MELD 评分>20 的 AUC 值分别为 0.877（95%CI：0.854-0.900）、0.935（95%CI：0.918-0.952）和 0.861（95%CI：0.835-0.887）（所有 p<0.001）。
LC 患者的 Tp-e、Tp-e/QT 和 Tp-e/QTc 值明显更高。这些指标可用于心律失常风险分层和预测疾病终末期。
