A doença arterial coronariana e o envelhecimento populacional: como enfrentar esse desafio?Coronary artery disease and populational ageing: how to deal with this challenge?
BackgroundThere is still debate about the relationship between changes in ventricular
repolarization on the surface electrocardiogram and cirrhosis severity.ObjectiveTo study the relationship between variables related to ventricular
repolarization and the clinical severity of the cirrhotic disease.MethodsWe selected 79 individuals with hepatic cirrhosis, classified according to
the Child-Pugh-Turcotte criteria (Child A, B, and C). We measured the QT and
corrected QT (QTc) intervals, and the interval between the peak and the end
of the T wave (TpTe), and we identified their minimum, maximum, and mean
values in the 12-lead electrocardiogram. We also calculated the dispersion
of the QT (DQT) and QTc (DQTc) intervals.ResultsIn 12 months of clinical follow-up, nine subjects underwent hepatic
transplantation (Child A: 0 [0%]; Child B: 6 [23.1%]; Child C: 3 [18.8%]; p
= 0.04) and 12 died (Child A: 3 [12.0%]; Child B: 4 [15.4%]; Child C: 5
[31.3%]; p = 0.002). No significant differences were observed between the
cirrhotic groups related to the minimum, maximum, and mean values for the
QT, QTc, TpTe, DQT, and DQTc intervals. A minimum TpTe interval ≤ 50
ms was a predictor for the composite endpoints of death or liver
transplantation with a sensitivity of 90% and a specificity of 57% (p =
0.005). In the Cox multivariate analysis, the Child groups and a minimum
TpTe of ≤ 50 ms were independent predictors of the composite
endpoints.ConclusionThe intervals QT, QTc, DQT, DQTc, and TpTe have similar distributions between
different severity stages in cirrhotic disease. The TpTe interval proved to
be a prognostic marker in subjects with cirrhosis, regardless of disease
severity (NCT01433848).
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