肝硬変におけるQTと転帰。補正が必要な因果関係についての長引く議論

QT and Outcomes in Cirrhosis: A prolonged debate on causality in need of correction.

• Nikhilesh R Mazumder
• Lisa B VanWagner

抄録

移植分野の進歩に伴い、肝移植（LT）後の早期死亡原因の第一位は、移植片不全や感染症に次いで心血管イベントとなっている。この傾向は、心代謝の危険因子が増加している高齢者や病状の悪い患者の移植によって強化されており、どの患者がより広範な心臓評価を受けるべきかを判断する必要性が強調されています。心電図（ECG）は何十年にもわたって周術期リスクの層別化に使用されてきたが、特に心拍数を補正したQT間隔（QTc）が注目されてきた。

As the field of transplant has advanced, cardiovascular events have become the leading cause of early death after liver transplantation (LT) ahead of graft failure and infection. This trend has been bolstered by the transplantation of older and sicker patients who have an increasing amount of cardiometabolic risk factors, accentuating the need to determine which patients should undergo more extensive cardiac evaluation. The electrocardiogram (ECG) has been used for decades for perioperative risk stratification, and in particular the QT interval corrected for heart rate (QTc) has been of interest.

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