QT interval prolongation in liver cirrhosis: innocent bystander or serious threat?
QT interval prolongation in liver cirrhosis: innocent bystander or serious threat?
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DOI：
10.1586/egh.11.86
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发表时间：
2012-02-01
影响因子：
3.9
通讯作者：
Zaccherini, Giacomo
中科院分区：
文献类型：
--
作者：
Bernardi, Mauro;Maggioli, Caterina;Zaccherini, Giacomo
ECG QT间期测量心室收缩的长度。其延长基本上是由延迟的复极相引起的，并且与室性心律失常和几种先天性和后天性疾病中猝死的风险增加有关。肝硬化患者的心脏电生理异常已被充分证实，QT间期延长已成为硬化性心肌病的电生理标志。本文将重点介绍：首先，肝硬化QT间期延长的流行病学; 2其次，这种电生理异常的发病机制和循环心脏毒素的假定作用的潜在分子机制; 3第三，其预后意义;第四，它的临床意义，在使用已知药物治疗的心律失常患者中，QT间期延长与室性心律失常发生之间的相关性QT间期延长或暴露于应激条件下，如肝移植、胃肠道出血和休克。
The ECG QT interval measures the length of ventricular systole. Its prolongation is essentially caused by a delayed repolarization phase, and is associated with an increased risk of ventricular arrhythmias and sudden death in several congenital and acquired conditions. Abnormalities in cardiac electrophysiology are well documented in patients with liver cirrhosis, and the prolonged QT interval has emerged as the electrophysiological hallmark of cirrhotic cardiomyopathy. This article will focus on: first, the epidemiology of QT interval prolongation in cirrhosis; second, the potential molecular mechanisms responsible for the pathogenesis of this electrophysiological abnormality and the putative role of circulating cardiotoxins; third, its prognostic meaning; and fourth, its clinical relevance, in terms of the association between the presence of a long QT interval and the occurrence of ventricular arrhythmias in cirrhotic patients treated with drugs known to increase the QT length or exposed to stressful conditions, such as liver transplantation, gastrointestinal bleeding and shock.