The risk factors of QTc interval prolongation in patients with liver cirrhosis

Abstract

Abstract: Objective To explore the risk factors for the occurrence of QTc interval prolongation in patients with liver cirrhosis, so as to provide a basis for taking appropriate intervention measures in clinical diagnosis and treatment activities, with the aim of reducing the risk of QTc interval prolongation in cirrhotic patients. Methods The data of 648 patients diagnosed with liver cirrhosis during their hospitalization in People′s Hospital of Hunan Province (the First Affiliated Hospital of Hunan Normal University) from January 2020 to December 2023 were retrospectively collected. According to whether the QTc interval was prolonged or not, the patients were divided into a group with QTc interval < 440 ms (275 cases) and a group with QTc interval ≥ 440 ms (373 cases). The clinical characteristics, laboratory tests and examination indicators of the patients in these two groups were compared, and the relevant risk factors for the occurrence of QTc interval prolongation in patients with liver cirrhosis were analyzed. Results By comparing the data of the patients in the two groups and performing univariate logistic regression analysis, it was shown that there were statistically significant differences in Child-Pugh score, moderate to massive ascites, hypertension, left ventricular end-diastolic diameter (LVEDD), left ventricular posterior wall thickness at end-diastolic (LVPWd), filling peak of rapid filling during late diastole of the mitral valve orifice (A wave), hemoglobin (Hb), platelet (PLT), prothrombin activity (PTA), albumin (Alb), globulin (GLB), total bilirubin (TBil), total bile acid (TBA), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), potassium (K), sodium (Na), calcium (Ca) and creatine kinase-MB (CK-MB) (P<0.05). Univariate analysis showed that all of the above-mentioned indicators were statistically significant (P<0.05).The results of multivariate binary logistic regression analysis showed that hypertension, LVPWd, A peak, Hb, GLB, and K were independent influencing factors for the prolongation of the QTc interval in patients with liver cirrhosis (with odds ratios of 2.145, 1.178, 3.772, 0.990, 1.044, 0.639 respectively, P<0.05). ROC curves were plotted with LVPWd, A peak, Hb, GLB, K and the combined variable (a combination of the five variables) as the test variables. The results showed that the areas under the curve (AUC) were 0.700, 0.565, 0.602, 0.625, 0.614 and 0.573 respectively. Conclusion Hypertension, LVPWd, A peak, Hb, GLB, and K are independent influencing factors for the prolongation of the QTc interval in cirrhotic patients. These indicators should be highly emphasizedand effectively intervented s in clinical work, hould be promptly formulated and implemented to reduce the risk of QTc interval prolongation in patients.

Key words: Liver cirrhosis, Electrocardiogram, QTc interval, Risk factors

Jiang Huaye, Fan Yongmei. The risk factors of QTc interval prolongation in patients with liver cirrhosis[J]. Chinese Hepatolgy, 2026, 31(8): 1101-1106.

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