Q‐T interval (QTC) in patients with cirrhosis: relation to vasoactive peptides and heart rate

Autor:	A. L. Gerbes, Søren Schifter, Stefan Fuglsang, Flemming Bendtsen, Jens H. Henriksen, V. Gülberg, Sören Möller
Rok vydání:	2007
Předmět:	Adult Liver Cirrhosis Male medicine.hormone medicine.medical_specialty Cirrhosis Calcitonin Gene-Related Peptide Long QT syndrome Clinical Biochemistry Blood Pressure Calcitonin gene-related peptide QT interval Endothelins Electrocardiography Catecholamines Heart Rate Reference Values Internal medicine Hypertension Portal Heart rate medicine Humans education Aged Endothelin-3 education.field_of_study Endothelin-1 business.industry Cardiac Pacing Artificial Hemodynamics General Medicine Middle Aged medicine.disease Endothelin 3 Long QT Syndrome Blood pressure Cardiology Female business
Zdroj:	Scandinavian Journal of Clinical and Laboratory Investigation. 67:643-653
ISSN:	1502-7686 0036-5513
Popis:	Prolonged Q-T interval (QT) has been reported in patients with cirrhosis who also exhibit profound abnormalities in vasoactive peptides and often present with elevated heart rate (HR). The aim of this study was to relate QT to the circulating level of endothelins (ET-1 and ET-3) and calcitonin gene-related peptide (CGRP) in patients with cirrhosis. In addition, we studied problems with HR correction of QT.Forty-eight patients with cirrhosis and portal hypertension were studied during a haemodynamic investigation. Circulating levels of ETs and CGRP were determined by radioimmunoassays. Correction of QT for HR above 60 beats per min was performed using the methods described by Bazett (QT(C)) and Fridericia (QT(F)).Prolonged QT(C) (above 440 ms), found in 56% of the patients, was related to the presence of significant portal hypertension and liver dysfunction (p0.05 to 0.001), but not to elevated ET-1, ET-3 or CGRP. When corrected according to Bazett, QT(C) showed no significant relation to differences in HR between patients (r = 0.07, ns). QTF showed some undercorrection of HR (r = -0.36; p0.02). During HR variation in the individual patient, QT(C) revealed a small but significant overcorrection (2.6 ms per heartbeat per min; p0.001). This value was significantly (p0.02) smaller with QTF (1.2 ms per heartbeat per min).The prolonged QT(C) in cirrhosis is related to liver dysfunction and the presence of portal hypertension, but not to the elevated powerful vasoconstrictor (ET-1) or vasodilator (CGRP, ET-3) peptides. The problems with correction of the QT for elevated HR in cirrhosis are complex, and the lowest HR should be applied for determination of the QT.
Databáze:	OpenAIRE
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