Acute non-selective β-adrenergic blockade reduces prolonged frequency-adjusted Q-T interval (QTc) in patients with cirrhosis

Background/Aims: Earlier studies have shown a prolonged frequency-adjusted Q-T interval (QT(c) > 0.440 s(1/2)) in a substantial fraction of patients with cirrhosis. The effect of beta-blockade on QT(c) is unknown, and its determination was the aim of the study. Methods: Seventeen patients with cirrhosis received 80 mg propranolol orally during a haemodynamic investigation with measurements at baseline and 90 min after propranolol ingestion. Results: beta-Blockade reduced cardiac output (-21%, P < 0.001), heart rate (-20%, P < 0.001), and the hepatic venous pressure gradient (HVPG, -17%, P < 0.02). The mean QT(c) = 0.460 s(1/2) was prolonged compared to 0.410 s(1/2) in age-matched controls (P < 0.01). Whereas QT(c) decreased during beta-blockade in the cirrhotic patients (from 0.460 to 0.440 s(1/2), p < 0.01), no effect was found in the subgroup with normal QT(c) (0.429 vs. 0.422 s(1/2), ns), and a reduction was seen in the patients with prolonged QT(c) (from 0.488 to 0.456 s(1/2), p < 0.01). The percentage decrease in QT(c) was related to the reduction in HVPG (r = 0.48, P = 0.03) and cardiac output (r = 0.56, P = 0.02). Conclusions: Acute non-selective beta-blockade reduces prolonged QT(c) towards normal values in patients with cirrhosis. The clinical significance of QT(c) reduction in arrhythmia is a topic for future research. (C) 2003 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.