QTc prolongation in patients of cirrhosis and its relation with disease severity: An observational study from a rural teaching hospital

Abstract

Introduction: Cirrhotic cardiomyopathy is characterised by increased baseline cardiac output, systolic and diastolic dysfunction, diminished cardiovascular response to stressful stimuli and electrophysiological abnormalities in patients of cirrhosis in the absence of any underlying cardiac disease. QTc prolongation has been described as a common electrocardiographic abnormality in cirrhosis patients.

Aims and objectives: This study was done to evaluate the prevalence of QTc changes in patients of cirrhosis coming to a rural tertiary care centre and to analyse its correlation with disease severity.

Materials and methods: The present study was conducted on 100 patients suffering from cirrhosis of liver presented to the department of medicine. Around 100 age and sex-matched individuals were recruited as controls. The Child-Pugh score was used to determine the disease severity in cirrhosis patients. Standard 12-lead ECG was recorded in all cases and controls.

Results: Prolongation of QTc interval on ECG was observed in the majority (80%) of cirrhosis patients and it was significantly higher as compared to the healthy controls (P <0.01). The prolongation of QTc was significantly associated with the duration of disease (P <0.05) and disease severity as measured by the Child-Pugh score (P <0.01).

Conclusion: QTc prolongation on ECG may be an early marker of cardiac involvement in patients of cirrhosis and is significantly associated with disease severity.

Keywords: Cardiomyopathy; Child-Pugh score; QTc interval; cirrhosis.