Alterations in Corrected QT Interval Following Liver Transplant in Patients With End-Stage Liver Disease

作者：Zurick Andrew O III^*; Spier Bret J; Teelin Thomas C; Lorenze Katelin R; Alberte Cesar; Zacks Steven; Lindstrom Mary J; Pfau Patrick R; Selzman Kimberly

来源：Clinical Cardiology, 2010, 33(11): 672-677.

DOI：10.1002/clc.20801

Background: Studies have demonstrated that patients with end-stage liver disease (ESLD) often have a prolonged corrected QT interval (QTc) with variable changes in the QTc post-transplant. We sought to characterize the prevalence and degree of QTc prolongation in ESLD patients, identify risk factors for QTc prolongation, and assess changes in QTc following transplant.
Hypothesis: QTc interval is prolonged in ESLD patients pre-transplant due to a variety of risk factors and shortens following liver transplantation.
Methods: We conducted a retrospective, multicenter study utilizing 2 large liver-transplant databases. QTc intervals were calculated utilizing Bazett's formula. The cutoff used for prolonged QTc was 440 milliseconds for men and 460 milliseconds for women.
Results: There were 269 patients (169 men, loo women) included in the final analysis. The mean pre-transplant QTc was prolonged (449.0 ms), whereas the mean post-transplant QTc shortened and was within normal limits (416.7 ms) (P < 0.0001). QTc shortened after transplant in 87% of patients. QTc normalized in 70% of patients. Age and Model for End-Stage Liver Disease (MELD) score were not predictive of prolonged QTc at baseline.
Conclusions: ESLD patients often have a prolonged QTc, which frequently shortens or normalizes after transplant. Screening for prolonged QTc is warranted if medications known to prolong the QTc interval are used in ESLD patients pre-transplant. MELD score, age, and sex were not predictive of prolonged QTc at baseline.

• 出版日期2010-11