Electrocardiographic findings in hepatic cirrhosis and their association with the severity of disease
Date
2017Author
Pourafkari, L
Ghaffari, S
Nazeri, L
Lee, JB
Masnadi-Shirazi, K
Tajlil, A
Nader, ND
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Purpose/aim: Previous studies reported prolongation of QT interval in cirrhotic patients. We aimed to investigate the electrocardiographic changes and their correlation with the disease severity in cirrhotic patients. Methods: Sixty-nine cirrhotic patients were examined. The prolongation of corrected QT interval and low-voltage QRS in electrocardiography were cross-examined for clinical and biochemical data. The association of electrocardiographic findings with the severity of cirrhosis, as determined by both Child-Pugh and model for end-stage liver diseases (MELD) scores, was investigated. Results: QT-interval prolongation was detected in 63.5% patients and 57.7% met the criteria for low-voltage QRS. Patients with prolonged QT-interval had higher Child scores (9.58 +/- 2.5 vs. 8.16 +/- 2.29 respectively, P = 0.04) but model for end-stage liver diseases scores was similar in those with prolonged QT and low-voltage electrocardiogram. The frequency of prolonged QT interval and low-voltage QRS were similar among patients with different Child-Pugh classes. Heart rate was also higher in patients with low-voltage electrocardiogram (89 +/- 15 beats/min vs. 79 +/- 16 beats/min, P = 0.01). Mean QRS voltage in precordial leads was lower in those with ascites (8.5 +/- 2.6 mV vs. 11.8 +/- 3.4 mV, P = 0.006). Conclusion: Electrocardiographic changes are common in cirrhosis regardless of the disease severity. Low-voltage QRS may be related to anthropomorphic changes and development of ascites in these patients. Published by Elsevier Sp. z o.o. on behalf of The Czech Society of Cardiology.