title: Diastolic dysfunction, prolonged QTc interval and pericardial effusion as predictors of mortality in acute pancreatitis.
abstract: OBJECTIVE
  The cardiac changes in acute pancreatitis have been earlier studied but the data on their prognostic significance is limited. This study was done to determine electrocardiographic (ECG) and echocardiographic changes in acute pancreatitis and determine their prognostic significance.
  
  
  METHODS
  Fifty-two consecutive patients (mean age 36.5 ± 11 years (44 males)) with acute pancreatitis and without prior cardiovascular comorbidites were prospectively enrolled and subjected to clinical, laboratory and radiological investigation. ECG and echocardiography was done at admission and during follow up.
  
  
  RESULTS
  Seventeen patients (32.7%) had mild pancreatitis and 35 (67.3%) patients had severe pancreatitis. Sinus tachycardia was the most common ECG abnormality. QTc prolongation was seen in 30/52 (57.7%) patients. On echocardiography, no patient had systolic dysfunction but 31/52 (59.6%) patients had diastolic dysfunction. All 22 patients with QTc interval < 440 ms survived compared with 8/30 patients with QTc interval ≥ 440 ms who died (P = 0.01). All eight patients who died had evidence of diastolic dysfunction (100%). None of the patients without diastolic dysfunction succumbed to illness (P = 0.02). Pericardial effusion was present in 6/52 (11.5%) patients. Of the eight patients who died, pericardial effusion was present in three (37.5%) patients and this frequency was significantly higher than that in patients who recovered (3/44 [6.8%]; P = 0.04).
  
  
  CONCLUSIONS
  Electrocardiographic and echocardiographic changes are seen in more than 50% of patients with acute pancreatitis. Prolonged QTc interval, pericardial effusion and diastolic dysfunction are associated with higher mortality.
authors: Departments of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors: Nikhil
authors: N
authors: Nadkarni
authors: Deepak Kumar
authors: DK
authors: Bhasin
authors: Surinder Singh
authors: SS
authors: Rana
authors: Ajay
authors: A
authors: Bahl
authors: Saroj Kant
authors: SK
authors: Sinha
authors: Chalapathi
authors: C
authors: Rao
authors: Kewal Kishan
authors: KK
authors: Talwar
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology; D016009:Chi-Square Distribution; D003971:Diastole; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology; D010490:Pericardial Effusion / Q000209:etiology / Q000401:mortality*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D018754:Ventricular Dysfunction / Q000175:diagnosis / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology; D016276:Ventricular Function; D055815:Young Adult