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- W4385196632 abstract "Background and Aim: Reduced cardiac contractility due to cirrhotic cardiomyopathy, along with reduced cardiac output and mean arterial pressure, predisposes to renal dysfunction and HRS in CLD. Hence, whether QT interval prolongation, a marker of cardiac dysfunction in cirrhosis, can predict the development of HRS following an episode of acute variceal bleeding is the aim of study. Methods: A prospective cohort study was conducted among 164 cirrhotic patients with acute variceal bleeding. These patients were grouped into two, those having HRS and without having HRS. The study period was 1 year. All patients were evaluated before bleeding, during bleeding and 6 weeks later. Results: In this study 89 patients (54.2%) had prolonged QT interval during acute variceal bleeding. At baseline, the mean QT was 412.3 ms, which showed a significant prolongation during the time of variceal bleeding to 449.3 ms, and reduction to baseline at 6 weeks follow up to 413.2ms (p <0.001). It was further found out that QT interval prolongation was having statistically significant association with HRS and QT interval value of >467.5 ms independently predicts the development of HRS with a sensitivity of 58.5% and specificity of 86.6%. Factors found to be having statistically significant association with HRS include ascites, QTc interval during the time of bleeding, INR, Serum sodium, Liver size in USG & MELD score. QTc interval, MELD score &INR was found to be independent predictors of HRS. The best cut-off values were found to be >467.5ms for QTc interval, >19 for MELD score &>1.82 for INR. Conclusion: Acute variceal bleeding causes further prolongation of QT interval in Cirrhosis, and it is an independent predictor of HRS. The combination of QTc interval, MELD score & INR can aid in early detection of patients at increased risk of developing Bleed-precipitated HRS, thus improving their outcome." @default.
- W4385196632 created "2023-07-25" @default.
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- W4385196632 date "2023-01-01" @default.
- W4385196632 modified "2023-09-27" @default.
- W4385196632 title "QT Interval Prolongation: As a Predictor of Hepatorenal Syndrome in Cirrhotic Patients With Acute Variceal Bleeding" @default.
- W4385196632 doi "https://doi.org/10.1016/j.jceh.2023.07.291" @default.
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