title: QT Interval Prolongation and QRS Voltage Reduction in Patients with Liver Cirrhosis.
abstract: BACKGROUND
  Liver cirrhosis is associated with functional abnormalities of the cardiovascular system with co-existing electrocardiographic (ECG) abnormalities.
  
  
  OBJECTIVE
  The aim was to analyze ECG changes in patients with cirrhosis, to evaluate whether alcoholic etiology of cirrhosis and ascites has an impact on ECG changes.
  
  
  METHODS
  The study involved 81 patients with previously untreated alcoholic cirrhosis (64 patients with ascites, classes B and C according to the Child-Pugh classification; and 17 without ascites, categorized as class A); 41 patients with previously untreated cirrhosis due to chronic hepatitis C (HCV--30 patients with ascites, classes B and C; and 11 without ascites, class A); 42 with alcoholic steatohepatitis and 46 with alcoholic steatosis. The control group consisted of 32 healthy volunteers. Twelve-lead ECG recordings were performed and selected parameters were measured.
  
  
  RESULTS
  Significantly longer QT and QTc intervals and lower QRS voltage were found in patients with alcoholic and HCV cirrhosis compared to the controls. Significantly lower QRS voltage was found in subjects with ascites than in those without ascites. Removal of ascites significantly increased QRS voltage.
  
  
  CONCLUSIONS
  In cirrhosis, irrespective of etiology, ECG changes involved prolonged QT and QTc intervals and reduced QRS voltage. Prolonged QT and QTc intervals were not related to the severity of cirrhosis or to the presence of ascites. However, low QRS voltage was associated with the presence of ascites. Removal of ascites reverses low QRS voltage.
authors.affiliation: Department of Gastroenterology, Medical University of Lublin, Poland.
authors.forename: Halina
authors.initials: H
authors.lastname: Cichoż-Lach
authors.affiliation: Department of Cardiology, Medical University of Lublin, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Tomaszewski
authors.affiliation: Department of Gastroenterology, Medical University of Lublin, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Kowalik
authors.affiliation: Department of Gastroenterology, Medical University of Lublin, Poland.
authors.forename: Emilia
authors.initials: E
authors.lastname: Lis
authors.affiliation: Department of Cardiology, Medical University of Lublin, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Tomaszewski
authors.affiliation: Student of the Second Faculty of Medicine, Medical University of Lublin, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Lach
authors.affiliation: Independent Public Clinical Hospital No. 4 in Lublin, Poland.
authors.forename: Sylwia
authors.initials: S
authors.lastname: Boczkowska
authors.affiliation: Department of Gastroenterology, Medical University of Lublin, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Celiński
mesh_terms: D000200:Action Potentials; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D001201:Ascites / Q000209:etiology / Q000628:therapy; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006521:Hepatitis, Chronic / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy / Q000821:virology; D008104:Liver Cirrhosis, Alcoholic / Q000175:diagnosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors