Key result
Higher baseline EDVI is linked to ~6% greater odds of marked post-reperfusion QTc prolongation.
Why the study?
Structural alterations in the cirrhotic heart may contribute to electromechanical abnormalities such as QT prolongation during pediatric liver transplantation, but the relationship with baseline echocardiographic parameters was unclear.
Are pretransplant increases in left ventricular volume and mass associated with QT prolongation during pediatric liver transplantation?
Observational (n=39)
Are pretransplant increases in left ventricular volume and mass associated with QT prolongation during pediatric liver transplantation?
Odds Ratio: 1.06
p-value: p=0.027
In children with chronic liver disease undergoing liver transplantation, increased pretransplant ventricular volumes and mass are associated with an increased risk of intraoperative QTc prolongation.
Baseline QTc prolongation affects nearly half of pediatric LT candidates; leaves open whether echo parameters predict intraoperative risk.
Structural alterations in the cirrhotic heart may contribute to electromechanical abnormalities, represented by QT prolongation. The aim of this study was to investigate the changes in QTc according to the operative stage during pediatric LT and to identify which baseline echocardiographic parameters were associated with intraoperative QTc prolongation. Data were evaluated from 39 children undergoing LT for chronic liver disease (median age 9 months). In 19 patients (48.7%), baseline QTc was prolonged ≥440 ms (462 ± 19 ms). Through the period of post‐reperfusion, QTI, QTc, and JTI progressively increased, although values partially recovered toward the end of surgery. High LVMI (≥82.51 g/m2) was associated with baseline QTc ≥ 440 ms (OR = 1.034, P = .032). In the 5 minutes post‐reperfusion stage, marked QTc prolongation (defined as QTc ≥ 500 ms; n = 24, 61.5%) was significantly associated with high EDVI (OR = 1.060, P = .027) and SVI (OR = 1.075, P = .026). In children with chronic liver disease, increased ventricular volumes and mass may increase the risk of QTc prolongation during LT, suggesting that repolarization abnormalities might be contributed by structural changes characteristic of cirrhotic cardiomyopathy.
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Cho et al. (2018) conducted an observational in chronic liver disease (n=39). High end-diastolic volume index (EDVI) was evaluated on marked QTc prolongation (QTc ≥ 500 ms) at 5 minutes post-reperfusion (OR 1.060, p=0.027). High baseline end-diastolic volume index was significantly associated with marked QTc prolongation at 5 minutes post-reperfusion during pediatric liver transplantation (OR 1.060, P=0.027).
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