Journal of Hepatology

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Prolonged QTc interval in mild portal hypertensive cirrhosis, 16 June 2005
Ytting H, Henriksen JH, Fuglsang S, Bendtsen F, Møller S
pages 637-644
Background/Aims
The QTc interval is prolonged in a substantial fraction of patients with cirrhosis, thus indicating delayed repolarisation. However, no information is available in mild portal hypertensive patients. We therefore determined the QTc interval in cirrhotic patients with hepatic venous pressure gradient (HVPG)<12mmHg.
Methods
Forty-four patients with cirrhosis and HVPG<12mmHg underwent a haemodynamic study. They were compared with 36 cirrhotic patients with clinically significant portal hypertension (HVPG≥12mmHg) and controls without liver disease.
Results
The fraction with prolonged QTc interval (>0.440s1/2) was similar in the two cirrhotic groups (49 vs 50%, ns) and significantly above that of the controls (5%, P<0.005). QTc was normal in patients with normal HVPG. Likewise, mean QTc was 0.449 and 0.447s1/2 in the two cirrhotic groups (ns), values which are significantly above that of the controls (0.410s1/2, P<0.01). In the mild portal hypertensive group, the QTc interval was inversely related to indicators of liver function, such as indocyanine green clearance (r=?0.34, P<0.02).
Conclusions
Delayed repolarisation of the myocardium already occurs in a substantial fraction of patients with cirrhosis with only a mild increase in portal pressure. The prolonged QTc interval may be related to liver dysfunction and to the presence of portal hypertension.