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Prevalence of pre-transplant electrocardiographic abnormalities and post-transplant cardiac events in patients with liver cirrhosis

Josefsson, Axel; Fu, Michael; Bjoernsson, Einar and Kalaitzakis, Evangelos LU (2014) In BMC Gastroenterology 14.
Abstract
Background: Although cardiovascular disease is thouht to be common in cirrhosis, there are no systematic investigations on the prevalence of electrocardiographic (ECG) abnormalities in these patients and data on the occurrence of post-transplant cardiac events in comparison with the general population are lacking. We aimed to study the prevalence and predictors of ECG abnormalities in patients with cirrhosis undergoing liver transplantation and to define the risk of cardiac events post-transplant compared to the general population. Methods: Cirrhotic patients undergoing first-time liver transplantation between 1999-2007 were retrospectively enrolled. ECGs at pre-transplant evaluation were reviewed using the Minnesota classification and... (More)
Background: Although cardiovascular disease is thouht to be common in cirrhosis, there are no systematic investigations on the prevalence of electrocardiographic (ECG) abnormalities in these patients and data on the occurrence of post-transplant cardiac events in comparison with the general population are lacking. We aimed to study the prevalence and predictors of ECG abnormalities in patients with cirrhosis undergoing liver transplantation and to define the risk of cardiac events post-transplant compared to the general population. Methods: Cirrhotic patients undergoing first-time liver transplantation between 1999-2007 were retrospectively enrolled. ECGs at pre-transplant evaluation were reviewed using the Minnesota classification and compared to healthy controls. Standardized incidence ratios for post-transplant cardiac events were calculated. Results: 234 patients with cirrhosis were included, 186 with an available ECG (36% with alcoholic and 24% with viral cirrhosis; mean follow-up 4 years). Cirrhotics had a prolonged QTc interval, a Q wave, abnormal QRS axis deviation, ST segment depression and a pathologic T wave more frequently compared to controls (p<0.05 for all). Arterial hypertension, older age, cirrhosis severity and etiology were related to ECG abnormalities. Compared to the general Swedish population, patients were 14 times more likely to suffer a cardiac event post-transplant (p<0.001). A prolonged QTc interval and Q wave were related to post-transplant cardiac events (p<0.05 for all). Conclusions: Pre-transplant ECG abnormalities are common in cirrhosis and are associated with cardiovascular risk factors and cirrhosis severity and etiology. Post-transplant cardiac events are more common than in the general population. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Electrocardiography, Liver cirrhosis, Liver transplantation, Cardiac, events
in
BMC Gastroenterology
volume
14
publisher
BMC Biomedical Centre, Lund University
external identifiers
  • wos:000335263400001
  • scopus:84899918482
ISSN
1471-230X
DOI
10.1186/1471-230X-14-65
language
English
LU publication?
yes
id
c377334b-7208-4fbf-a6ad-1c030826b87c (old id 4487266)
date added to LUP
2014-07-01 07:31:59
date last changed
2017-07-30 04:20:18
@article{c377334b-7208-4fbf-a6ad-1c030826b87c,
  abstract     = {Background: Although cardiovascular disease is thouht to be common in cirrhosis, there are no systematic investigations on the prevalence of electrocardiographic (ECG) abnormalities in these patients and data on the occurrence of post-transplant cardiac events in comparison with the general population are lacking. We aimed to study the prevalence and predictors of ECG abnormalities in patients with cirrhosis undergoing liver transplantation and to define the risk of cardiac events post-transplant compared to the general population. Methods: Cirrhotic patients undergoing first-time liver transplantation between 1999-2007 were retrospectively enrolled. ECGs at pre-transplant evaluation were reviewed using the Minnesota classification and compared to healthy controls. Standardized incidence ratios for post-transplant cardiac events were calculated. Results: 234 patients with cirrhosis were included, 186 with an available ECG (36% with alcoholic and 24% with viral cirrhosis; mean follow-up 4 years). Cirrhotics had a prolonged QTc interval, a Q wave, abnormal QRS axis deviation, ST segment depression and a pathologic T wave more frequently compared to controls (p&lt;0.05 for all). Arterial hypertension, older age, cirrhosis severity and etiology were related to ECG abnormalities. Compared to the general Swedish population, patients were 14 times more likely to suffer a cardiac event post-transplant (p&lt;0.001). A prolonged QTc interval and Q wave were related to post-transplant cardiac events (p&lt;0.05 for all). Conclusions: Pre-transplant ECG abnormalities are common in cirrhosis and are associated with cardiovascular risk factors and cirrhosis severity and etiology. Post-transplant cardiac events are more common than in the general population.},
  articleno    = {65},
  author       = {Josefsson, Axel and Fu, Michael and Bjoernsson, Einar and Kalaitzakis, Evangelos},
  issn         = {1471-230X},
  keyword      = {Electrocardiography,Liver cirrhosis,Liver transplantation,Cardiac,events},
  language     = {eng},
  publisher    = {BMC Biomedical Centre, Lund University},
  series       = {BMC Gastroenterology},
  title        = {Prevalence of pre-transplant electrocardiographic abnormalities and post-transplant cardiac events in patients with liver cirrhosis},
  url          = {http://dx.doi.org/10.1186/1471-230X-14-65},
  volume       = {14},
  year         = {2014},
}