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Title: Effect of liver transplantation on QT-interval prolongation and impact on mortality.
Austin Authors: Ko, Jefferson ;Koshy, Anoop N ;Han, Hui-Chen ;Weinberg, Laurence ;Gow, Paul J ;Testro, Adam G ;Lim, Han S ;Farouque, Omar ;Teh, Andrew W 
Affiliation: Department of Cardiology, Eastern Health Clinical School, Monash University, Victoria, Australia
Victorian Liver Transplant Unit
The University of Melbourne, Parkville, Victoria, Australia
Issue Date: 1-Mar-2021
Date: 2020-11-10
Publication information: International Journal of Cardiology 2021; 326: 158-163
Abstract: QT-interval prolongation is considered the electrophysiological hallmark of cirrhotic cardiomyopathy. However, the significance of QT-interval prolongation and how it is affected by liver transplantation (LT) remains unclear. Consecutive inpatients undergoing LT between 2010 and 2017 at a state-wide liver transplant center in Australia were included. Preoperative, early postoperative and long-term follow-up corrected QT-intervals (QTc) were manually measured by a cardiologist. QTc was calculated using the Bazett formula and QTc ≥440 milliseconds (ms) was considered prolonged. Overall, 1111 ECG tracings among 408 patients (mean age 57 ± 12 years) were assessed. Pre-LT, 265 patients (65.0%) had QTc ≥440 ms and 24 patients (5.9%) had QTc ≥500 ms. In the early postoperative period, there was a significant increase in QTc compared to pre-LT (471 ± 39 vs. 452 ± 31 ms, p < 0.001) and 80 patients (20.3%) had QTc ≥500 ms. At a median of six months post-LT, there was significant reduction in mean QTc compared to pre-LT (430 ± 32 vs. 452 ± 31 ms; p < 0.001) with the QTc shortening in 73% of patients. QT-interval prolongation was not associated with postoperative complications or mortality at any time-point. QT-interval prolongation is common in patients with liver cirrhosis and this metric normalized in the majority within six months post-LT. A significant increase in QTc was noted early post-LT, with over 20% demonstrating QTc ≥500 ms. QT-interval prolongation was not associated with post-transplant complications or mortality. Resolution of QT-interval prolongation suggests that this feature of cirrhotic cardiomyopathy may reverse post-transplantation.
DOI: 10.1016/j.ijcard.2020.11.017
Journal: International Journal of Cardiology
PubMed URL: 33186663
Type: Journal Article
Subjects: Cirrhosis
Cirrhotic cardiomyopathy
Liver disease
Liver transplantation
QT interval
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