QT prolongation is associated with increased mortality in end stage liver disease

Kim, Sun Moon; George, Bennet; Alcivar-Franco, Diego; Campbell, Charles L.; Charnigo, Richard; Delisle, Brian P.; Hundley, Jonathan C.; Darrat, Yousef; Morales, Gustavo; Elayi, Samy-Claude; Bailey, Alison L.

doi:10.4330/wjc.v9.i4.347

Cited by 37 publications

(25 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A prolonged QT interval represents a common electrocardiographic finding in patients with cirrhosis and served as predictor of the increased risk of ventricular arrhythmia and/or sudden death [57]. QT prolongation has been attributed to the downregulation of β-adrenergic receptors after chronic exposure to noradrenalin [58].…”

Section: Electrophysiological Modificationsmentioning

confidence: 99%

Relationship between Heart Disease and Liver Disease: A Two-Way Street

Hadi

Vincenzo

Rossato

2020

Cells

103

125

View full text Add to dashboard Cite

In clinical practice, combined heart and liver dysfunctions coexist in the setting of the main heart and liver diseases because of complex cardiohepatic interactions. It is becoming increasingly crucial to identify these interactions between heart and liver in order to ensure an effective management of patients with heart or liver disease to provide an improvement in overall prognosis and therapy. In this review, we aim to summarize the cross-talk between heart and liver in the setting of the main pathologic conditions affecting these organs. Accordingly, we present the clinical manifestation, biochemical profiles, and histological findings of cardiogenic ischemic hepatitis and congestive hepatopathy due to acute and chronic heart failure, respectively. In addition, we discuss the main features of cardiac dysfunction in the setting of liver cirrhosis, nonalcoholic fatty liver disease, and those following liver transplantation.

show abstract

Section: Electrophysiological Modificationsmentioning

confidence: 99%

Relationship between Heart Disease and Liver Disease: A Two-Way Street

Hadi

Vincenzo

Rossato

2020

Cells

103

125

View full text Add to dashboard Cite

show abstract

“…Both CAN, even subclinical, and QT prolongation have been associated with increased all-cause mortality in patients with diabetes[ 7 - 9 ]. Interestingly, some studies have shown that the prolongation of QT interval in patients with cirrhosis has been associated with the severity and progression of the disease and with poorer survival in cirrhotic patients[ 10 - 13 ]. On the other hand, in other studies, even though prolonged QT was associated with more severe liver dysfunction, this has not been translated to higher mortality[ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Liver cirrhosis-effect on QT interval and cardiac autonomic nervous system activity

Tsiompanidis

Siakavellas

Tentolouris

et al. 2018

WJGP

View full text Add to dashboard Cite

AIMTo examine the impact of liver cirrhosis on QT interval and cardiac autonomic neuropathy (CAN).METHODSA total of 51 patients with cirrhosis and 51 controls were examined. Standard 12-lead electrocardiogram recordings were obtained and QT as well as corrected QT interval (QTc) and their dispersions (dQT, dQTc) were measured and calculated using a computer-based program. The diagnosis of CAN was based upon the battery of the tests proposed by Ewing and Clarke and the consensus statements of the American Diabetes Association. CAN was diagnosed when two out of the four classical Ewing tests were abnormal.RESULTSQT, QTc and their dispersions were significantly longer (P < 0.01) in patients with cirrhosis than in controls. No significant differences in QT interval were found among the subgroups according to the etiology of cirrhosis. Multivariate regression analysis after controlling for age, gender and duration of cirrhosis demonstrated significant association between QT and presence of diabetes mellitus [standardized regression coefficient (beta) = 0.45, P = 0.02] and treatment with diuretics (beta = 0.55, P = 0.03), but not with the Child-Pugh score (P = 0.54). Prevalence of CAN was common (54.9%) among patients with cirrhosis and its severity was associated with the Child-Pugh score (r = 0.33, P = 0.02). Moreover, patients with decompensated cirrhosis had more severe CAN that those with compensated cirrhosis (P = 0.03). No significant association was found between severity of CAN and QT interval duration.CONCLUSIONPatients with cirrhosis have QT prolongation. Treatment with diuretics is associated with longer QT. CAN is common in patients with cirrhosis and its severity is associated with severity of the disease.

show abstract

“…The reasons that AF is linked to higher mortality and morbidity are likely higher rates of stroke and acute kidney injury (AKI). Also, long QT is commonly seen in advanced liver disease and is a strong predictor of increased death[ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Mortality and morbidity in patients with atrial fibrillation and liver cirrhosis

Darrat¹,

Smer²,

Elayi³

et al. 2020

WJC

View full text Add to dashboard Cite

BACKGROUND Atrial fibrillation (AF) is the most common cardiac arrhythmia encountered in clinical practice. However, the outcomes associated with AF in hospitalized patients with liver cirrhosis are unknown. AIM To determine the outcomes of hospitalized patients with liver cirrhosis and AF. METHODS In this study, we examined morbidity and mortality of patients with concomitant AF and liver cirrhosis from the National Inpatient Sample database, the largest publicly available inpatient healthcare database in the United States. RESULTS A total of 696937 patients with liver cirrhosis were included, 45745 of whom had concomitant AF (6.6%). Liver cirrhosis patients with AF had higher rates of in-hospital mortality (12.6% vs 10.3%, P < 0.001), clinical stroke (1.6% vs 1.1%, P < 0.001), and acute kidney injury (28.2% vs 25.1%, P < 0.001), and less gastrointestinal bleeding (4.4% vs 5.1%, P < 0.001) and blood transfusion (22.5% vs 23.8%, P < 0.001) compared with those who did not have the arrhythmia. In addition, they had a longer length of stay (8 ± 10 d vs 7 ± 8 d, P < 0.001) and higher hospitalization costs (20720 ± 33210 $ vs 16272 ± 24166 $, P < 0.001). CONCLUSION In subjects with liver cirrhosis, AF is associated with higher rates of inpatient mortality, stroke, and acute kidney injury compared to those who do not have the cardiac arrhythmia.

show abstract

QT prolongation is associated with increased mortality in end stage liver disease

Cited by 37 publications

References 40 publications

Relationship between Heart Disease and Liver Disease: A Two-Way Street

Relationship between Heart Disease and Liver Disease: A Two-Way Street

Liver cirrhosis-effect on QT interval and cardiac autonomic nervous system activity

Mortality and morbidity in patients with atrial fibrillation and liver cirrhosis

Contact Info

Product

Resources

About