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Title: Relationship between QT-interval prolongation and structural abnormalities in cirrhotic cardiomyopathy: A change in the current paradigm.
Austin Authors: Koshy, Anoop N ;Gow, Paul J ;Testro, Adam G ;Teh, Andrew W ;Ko, Jefferson ;Lim, Han S ;Han, Hui-Chen ;Weinberg, Laurence ;VanWagner, Lisa B;Farouque, Omar 
Affiliation: Division of Gastroenterology & Hepatology and Preventive Medicine-Epidemiology Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
The University of Melbourne, Parkville, Victoria, Australia
Victorian Liver Transplant Unit
Issue Date: 16-Jan-2021 2021-01-16
Publication information: American Journal of Transplantation 2021; online first: 16 January
Abstract: It is postulated that cardiac structural abnormalities observed in cirrhotic cardiomyopathy (CCM) contribute to the electrophysiologic abnormality of QT-interval (QTc) prolongation. We sought to evaluate whether QTc prolongation is associated with intrinsic abnormalities in cardiac structure and function that characterize CCM. Consecutive patients undergoing liver transplant work-up between 2010-2018 were included. Measures of cardiac function on stress testing including cardiac reserve and chronotropic incompetence were collected prospectively and a corrected QTc≥440ms was considered prolonged. Overall, 439 patients were included and 65.1% had a prolonged QTc. There were no differences in markers of left ventricular and atrial remodelling, or resting systolic and diastolic function across QTc groups. The proportion of patients that met the criteria for a low cardiac reserve (39.2 vs 36.6%, p=0.66) or chronotropic incompetence (18.1 vs 21.3%, p=0.52) was not different in those with a QTc≥440 vs <440 ms. Further, there was no association between QTc-prolongation and CCM by either the 2005 World College of Gastroenterology or modified 2020 Cirrhotic Cardiomyopathy Consortium criteria. Conclusion: QT-interval prolongation was not associated with structural or functional cardiac abnormalities that characterize CCM. These findings suggest that CCM and QT-interval prolongation in cirrhosis may be two separate entities with distinct pathophysiological origins.
DOI: 10.1111/ajt.16500
ORCID: 0000-0002-8741-8631
PubMed URL: 33453141
Type: Journal Article
Appears in Collections:Journal articles

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