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Pediatr Transplant. 2018 Jun 15:e13237. doi: 10.1111/petr.13237. [Epub ahead of print]

Pretransplant increases in left ventricular volume and mass are associated with QT prolongation during pediatric liver transplantation.

Author information

1
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
2
Laboratory for Cardiovascular Dynamics and Signal Processing, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
3
Public Health Care Doctor, Hoengseong County Public Health Care Center, Gangwon-Do, Korea.

Abstract

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.

KEYWORDS:

QT interval; children; cirrhotic cardiomyopathy; liver transplantation

PMID:
29908011
DOI:
10.1111/petr.13237

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