Evaluation of QT Intervals in Compensated and Decompensated Chronic Hepatitis C Cirrhotic Patients

Khalil, Osama Ahmed; Fawzy, Mohamed Samy; EL-Naggar, Ashraf Khalifa; Sayed, Entesar Kamel

doi:10.21608/ejhm.2020.80836

Evaluation of QT Intervals in Compensated and Decompensated Chronic Hepatitis C Cirrhotic Patients

Document Type : Original Article

Authors

¹ Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig Egypt

² Medical Biochemistry Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt

³ Internal Medicine Department, Ahmed Maher Teaching Hospital, Egypt

10.21608/ejhm.2020.80836

Abstract

Background: Cirrhotic cardiomyopathy is chronic cardiac dysfunction in cirrhotic patients with no previous structural heart disease. QT prolongation is one of the most important cardiac alterations related to cirrhosis. Objective: This study was aimed to evaluate QT interval duration among compensated and decompensated chronic Hepatitis C (Ch HCV) cirrhotic patients and to detect its relation to biochemical changes in cirrhosis and its effect on patients’ outcome. Patients and Methods: A cross sectional study was conducted on 52 Ch HCV patients divided into two groups according to presence of signs of decompensation. Patients underwent clinical, laboratory and electrocardiographic evaluation. Cirrhosis severity was classified according to the Child-Pugh score. The QT interval in lead II (QTII), maximum QT (QTmax), heart rate corrected QTmax (msillisecond) obtained manually using by a 12-lead electrocardiogram. Results: Decompensated patients had non-significantly lower values of QTII and QT max. There was significant difference between both groups regarding QT maxc. 80.8% versus 38.5% of decompensated and compensated patients had prolonged QTC. There was significant relation between child class and QT parameters. There was significant relation between QT maxc prolongation and serum Albumin, sodium, ammonia, Urea, AFP and APACHE-II. There was significant relation between outcome and both QT max and QT maxc. Cutoff of QT max n predicting mortality was≥435 with sensitivity 80% and specificity 69%. QT maxc cutoff ≥508 predicted mortality with sensitivity 80% and specificity 84%. Conclusion: A prolonged QT maxc was prevalent among cirrhotic patients and this positively correlated with disease severity and high mortality.

Keywords