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. 2017 Apr 26;9(4):347-354.
doi: 10.4330/wjc.v9.i4.347.

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

Sun Moon Kim  1 , Bennet George  1 , Diego Alcivar-Franco  1 , Charles L Campbell  1 , Richard Charnigo  1 , Brian Delisle  1 , Jonathan Hundley  1 , Yousef Darrat  1 , Gustavo Morales  1 , Samy-Claude Elayi  1 , Alison L Bailey  1
Affiliations

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

Sun Moon Kim et al. World J Cardiol. .

Abstract

Aim: To determine the prevalence of QT prolongation in a large series of end stage liver disease (ESLD) patients and its association to clinical variables and mortality.

Methods: The QT interval was measured and corrected for heart rate for each patient, with a prolonged QT cutoff defined as QT > 450 ms for males and QT > 470 ms for females. Multiple clinical variables were evaluated including sex, age, serum sodium, international normalized ratio, creatinine, total bilirubin, beta-blocker use, Model for End-Stage Liver Disease (MELD), MELD-Na, and etiology of liver disease.

Results: Among 406 ESLD patients analyzed, 207 (51.0%) had QT prolongation. The only clinical variable associated with QT prolongation was male gender (OR = 3.04, 95%CI: 2.01-4.60, P < 0.001). During the study period, 187 patients (46.1%) died. QT prolongation was a significant independent predictor of mortality (OR = 1.69, 95%CI: 1.03-2.77, P = 0.039). In addition, mortality was also associated with viral etiology of ESLD, elevated MELD score and its components (P < 0.05 for all). No significant reversibility in the QT interval was seen after liver transplantation.

Conclusion: QT prolongation was commonly encountered in an ESLD population, especially in males, and served as a strong independent marker for increased mortality in ESLD patients.

Keywords: Arrhythmias; Cirrhosis; Electrophysiology; Liver transplantation; Mortality; QT prolongation.

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Conflict of interest statement

Conflict-of-interest statement: The authors of this manuscript have no conflict of interest to disclose.

Figures

Figure 1
Figure 1
Association of mortality with Model for End-Stage Liver Disease components and clinical variables.
Figure 2
Figure 2
Association of mortality with total Model for End-Stage Liver Disease score and clinical variables.
Figure 3
Figure 3
Association of mortality with total Model for End-Stage Liver Disease with incorporation of serum sodium score and clinical variables.
See this image and copyright information in PMC

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