Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2015, vol. 24, nr 4, July-August, p. 615–622

doi: 10.17219/acem/28681

Publication type: original article

Language: English

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QT Interval Prolongation and QRS Voltage Reduction in Patients with Liver Cirrhosis

Halina Cichoż-Lach1,A,C,D,F, Michał Tomaszewski2,B,C, Agnieszka Kowalik1,B,C, Emilia Lis1,B,C, Andrzej Tomaszewski2,B,C,D, Tomasz Lach3,B, Sylwia Boczkowska4,B, Krzysztof Celiński1,E,F

1 Department of Gastroenterology, Medical University of Lublin, Poland

2 Department of Cardiology, Medical University of Lublin, Poland

3 Student of the Second Faculty of Medicine, Medical University of Lublin, Poland

4 Independent Public Clinical Hospital No. 4 in Lublin, Poland

Abstract

Background. Liver cirrhosis is associated with functional abnormalities of the cardiovascular system with coexisting electrocardiographic (ECG) abnormalities.
Objectives. 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.
Material and 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.
Conclusion. 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.

Key words

ascites, liver cirrhosis, electrocardiography, QT interval, QRS voltage.

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