Prolonged Q–Tc interval in mild portal hypertensive cirrhosis

Background/Aims The Q–Tc interval is prolonged in a substantial fraction of patients with cirrhosis, thus indicating delayed repolarisation. However, no information is available in mild portal hypertensive patients. We therefore determined the Q–Tc interval in cirrhotic patients with hepatic venous pressure gradient (HVPG)<12 mmHg. Methods Forty-four patients with cirrhosis and HVPG<12 mmHg underwent a haemodynamic study. They were compared with 36 cirrhotic patients with clinically significant portal hypertension (HVPG≥12 mmHg) and controls without liver disease. Results The fraction with prolonged Q–Tc interval (>0.440 s1/2) was similar in the two cirrhotic groups (49 vs 50%, ns) and significantly above that of the controls (5%, P<0.005). Q–Tc was normal in patients with normal HVPG. Likewise, mean Q–Tc was 0.449 and 0.447 s1/2 in the two cirrhotic groups (ns), values which are significantly above that of the controls (0.410 s1/2, P<0.01). In the mild portal hypertensive group, the Q–Tc interval was inversely related to indicators of liver function, such as indocyanine green clearance (r=−0.34, P<0.02). Conclusions Delayed repolarisation of the myocardium already occurs in a substantial fraction of patients with cirrhosis with only a mild increase in portal pressure. The prolonged Q–Tc interval may be related to liver dysfunction and to the presence of portal hypertension.