QT Interval Prolongation in Cirrhotic Cardiomyopathy

The liver and the heart are related to each other in many aspects. So liver diseases affect the heart, and heart disease affects the liver. Hyperdynamic circulation, the inability of ventricular contractility, hypertrophy of the heart, and electrophysiological alteration of the heart (prolongation QT interval) are some complications of cirrhosis. The most known complication of cirrhosis in the heart is cirrhotic cardiomyopathy. The original definition of cirrhotic cardiomyopathy was stated at the World Congress of Gastroenterology (2015). It is characterized by cardiac alteration (both in structure and function) in patients with cirrhosis without previously known cardiac problems. The pathological mechanism of cirrhotic cardiomyopathy includes physiological and chemical changes in cardiac muscle cells and increased inhibition of cardiomyocytes. Beta-adrenergic receptors defect and desensitization, endogenous cannabinoids, and cardiomyocyte depressants (NO and inflammatory cytokines) decrease cardiac contractility. Forty to fifty percent of the patients with cirrhosis had QT interval prolongation. QT interval prolongation is the most known electrophysiological abnormality in cirrhotic cardiomyopathy. The main cause of QT interval prolongation is a receptor and ion channel defect and a change in membrane fluidity.