P0233 IMPACT OF LIVER TRANSPLANTATION ON RATE CORRECTED Q-T INTERVAL IN PATIENTS WITH CHRONIC LIVER DISEASE
Bildiriler > Özet Bildiri
Yazarlar: C. Arikan, G. Tumgor, Reşit Ertürk LEVENT, Funda ÇETİN, S. A. Akman, M. Kilic, R. V. Yagci, Sema AYDOĞDU
Journal of Pediatric Gastroenterology and Nutrition, , , Uluslararası, Özet Bildiri, Wos, cilt 39, ss S147-S147
DOI: 10.1097/00005176-200406001-00357
Özet
Introduction: Prolonged Q-T interval predicts severe arrhythmia and sudden death, and has been shown to occur in alcoholic liver disease and cirrhotic patients who are candidates for liver transplantation. In this study we evaluated children with chronic liver disease to determine whether they have abnormalities of ventricular repolarisation and effect of liver transplantation. Methods: Between December 2001–September 2003, 55 pediatric patients (median age 8 years; range 0.5–16, M/F:26/29, median PELD score 14; range 0–56) underwent evaluation for liver transplantation, including a 12-lead electrocardiogram and an echocardiogram. All patients had normal serum electrolytes, calcium, and magnesium at the time of cardiac evaluation and were not on any medications known to prolong repolarization. Rate-corrected Q-T interval (QTc) was assessed along with Child-Pugh score and Pediatric End Stage Liver Disease (PELD) score. Follow-up electrocardiograms were performed on survivors following liver transplantation. Results: Among those evaluated, 21 (43%) were noted to have a prolonged QT interval corrected for rate (QTc > 42 ms; range 42–56). All had a structurally normal heart. When compared patients with a prolonged QTc with a normal QTc interval, there was significant difference in mean PELD score and Child Pough score (p= 0.02, p=0.002 respectively). None of the patients developed a ventricular arrhythmia during follow up. Four of 29 patients with a prolonged QTc died prior to transplant and mean QTc was found significantly higher in these patients than survive without LT (0.46 ms vs 0.39 ms, p=0.009). 30 patients underwent LT and 5 of them died. Mean preoperative QTc was significantly higher in patients who died (p=0.04). Of the 14 patients with prolonged QTc, 7 (50%) normalized, four (28.5%) remained unchanged, 3 (21.5%) showed further prolongation. An additional 5 patients who had normal QTc before LT developed prolonged QTc after LT. Conclusion: While the mechanism is not known, QTc prolongation can be seen in a significant number of children with chronic liver disease. Prolonged QTc returns to normal values in about half of the patients after LT, suggesting that liver disease plays a role, but may not be the only factor in the pathogenesis of prolonged QTc. Furthermore developed prolonged QTc after LT arose that a possible role of calcineurine inhibitor in pathogenesis of ventricular repolarisation.