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

J Hepatol. 2004 Feb;40(2):239-46. doi: 10.1016/j.jhep.2003.10.026.


Background/aims: Earlier studies have shown a prolonged frequency-adjusted Q-T interval (QTc>0.440 s(1/2)) in a substantial fraction of patients with cirrhosis. The effect of beta-blockade on QTc 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 QTc=0.460 s(1/2) was prolonged compared to 0.410 s(1/2) in age-matched controls (P<0.01). Whereas QTc 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 QTc (0.429 vs. 0.422 s(1/2), ns), and a reduction was seen in the patients with prolonged QTc (from 0.488 to 0.456 s(1/2), P<0.01). The percentage decrease in QTc 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 QTc towards normal values in patients with cirrhosis. The clinical significance of QTc reduction in arrhythmia is a topic for future research.

Publication types

  • Clinical Trial

MeSH terms

  • Administration, Oral
  • Adrenergic beta-Antagonists / administration & dosage*
  • Blood Pressure / drug effects
  • Cardiac Output / drug effects
  • Female
  • Heart Rate / drug effects
  • Humans
  • Liver Cirrhosis, Alcoholic / complications*
  • Long QT Syndrome / drug therapy*
  • Male
  • Middle Aged
  • Propranolol / administration & dosage*
  • Vascular Resistance / drug effects


  • Adrenergic beta-Antagonists
  • Propranolol