Evaluation of the Electrocardiographic Tp-e, Tp-e/QT, and Tp-e/QTc Parameters in Patients with Non-Alcoholic Liver Disease

Background and Objectives: Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver disease associated with significant morbidity, including cardiovascular complications. This study investigates the relationship between NAFLD and electrocardiographic parameters indicative of ventricular arrhythmia risk. Materials and Methods: We conducted a cross-sectional study enrolling 136 patients with NAFLD and 136 healthy controls. Electrocardiographic parameters—Tp-e interval, QT and corrected QT (QTc) intervals, and Tp-e/QTc ratio—were measured and compared between groups. Results: Patients with NAFLD exhibited significantly higher Tp-e, QTc, Tp-e/QT ratio, and Tp-e/QTc ratio (p < 0.001, for all) than controls. Subgroup analysis showed progressive increases in Tp-e and Tp-e/QT ratio correlating with NAFLD severity (p < 0.001 and p = 0.001, respectively, for grade 1 vs. grade 2; p < 0.001 and p = 0.001, respectively, for grade 1 vs. grade 3). ROC analysis indicated that the Tp-e interval was a strong predictor for identifying grade 2 or more NAFLD (AUC 0.887, p < 0.001). Conclusions: Our findings highlight the association of NAFLD with prolonged electrocardiographic intervals that may predispose patients to ventricular arrhythmias. These parameters can serve as valuable markers for cardiac risk stratification in patients with NAFLD, suggesting the need for vigilant cardiac follow-up in this population.