title: Effects of orthotopic liver transplantation on the corrected QT interval in patients with end-stage liver disease.
abstract: Autonomic dysfunction is a recognized complication of end-stage liver disease (ESLD) associated with a poor prognosis. The corrected QT interval (QTc) on electrocardiogram is a marker of autonomic function. A few small studies have suggested that QTc may normalize with the return of liver function after orthotopic liver transplantation. We sought to determine how transplantation affects the QTc in patients with ESLD. The QTc from the pretransplantation evaluation of 46 patients with ESLD was compared with the QTc at 4-month posttransplantation follow-up. Other factors that can influence autonomic function also were evaluated. Most patients with ESLD (54%) showed a prolonged QTc (> or = 440 msec) at the pretransplantation evaluation (451 +/- 45 msec) that improved to within the normal range at posttransplantation follow-up (418 +/- 18 msec; P < 0.001). There was no relationship between QTc prolongation and Child-Turcotte-Pugh score, Model for End-Stage Liver Disease score, diabetes mellitus, age, or etiology of liver disease. Most patients with ESLD and a prolonged QTc will have a significant improvement in QTc after transplantation; however, 6.5% of patients in our study had a worsening of QTc after transplantation.
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, Arizona, USA.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Carey
authors.forename: David D
authors.initials: DD
authors.lastname: Douglas
mesh_terms: D001341:Autonomic Nervous System / Q000503:physiopathology; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008107:Liver Diseases / Q000503:physiopathology* / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period
references.citation: Transplantation. 1998 Aug 27;66(4):535-7
references.pmid: 9734501
references.citation: Am J Gastroenterol. 1990 Mar;85(3):288-92
references.pmid: 2309679
references.citation: Q J Med. 1989 Aug;72(268):737-47
references.pmid: 2602555
references.citation: J Hepatol. 2001 Dec;35(6):733-8
references.pmid: 11738100
references.citation: Jpn Heart J. 1998 May;39(3):321-9
references.pmid: 9711183
references.citation: Lancet. 1992 Jun 13;339(8807):1462-4
references.pmid: 1351136
references.citation: Hepatology. 1996 Mar;23(3):471-5
references.pmid: 8617426
references.citation: J Hepatol. 1997 Jun;26(6):1242-8
references.pmid: 9210610
references.citation: Transplantation. 1992 Apr;53(4):929-30
references.pmid: 1373538
references.citation: Pharmacotherapy. 2002 Dec;22(12):1632-7
references.pmid: 12495173
references.citation: Clin Transplant. 1996 Oct;10(5):408-13
references.pmid: 8930453
references.citation: J Hepatol. 1992 Sep;16(1-2):177-83
references.pmid: 1336506
references.citation: Hepatology. 1999 Dec;30(6):1387-92
references.pmid: 10573516
references.citation: Hepatology. 1996 May;23(5):1128-34
references.pmid: 8621144
references.citation: Hepatology. 1998 Jan;27(1):28-34
references.pmid: 9425913
references.citation: Transplant Proc. 1999 Sep;31(6):2366-7
references.pmid: 10500620
references.citation: Liver Int. 2003 Aug;23(4):243-8
references.pmid: 12895263
references.citation: J Intern Med. 1997 Sep;242(3):225-9
references.pmid: 9350167