title: Alterations in corrected QT interval following liver transplant in patients with end-stage liver disease.
abstract: 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.
  
  
  OBJECTIVE
  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, 100 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.
authors.affiliation: Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. zuricka@ccf.org
authors.forename: Andrew O
authors.initials: AO
authors.lastname: Zurick
authors.forename: Bret J
authors.initials: BJ
authors.lastname: Spier
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Teelin
authors.forename: Katelin R
authors.initials: KR
authors.lastname: Lorenze
authors.forename: Cesar
authors.initials: C
authors.lastname: Alberte
authors.forename: Steven
authors.initials: S
authors.lastname: Zacks
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Lindstrom
authors.forename: Patrick R
authors.initials: PR
authors.lastname: Pfau
authors.forename: Kimberly
authors.initials: K
authors.lastname: Selzman
mesh_terms: D004562:Electrocardiography; D058625:End Stage Liver Disease / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D016014:Linear Models; D016031:Liver Transplantation; D016015:Logistic Models; D008133:Long QT Syndrome / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States