Clinical implication of electrocardiogram change in patients experiencing lung transplantation with end stage lung disease

• Published in: Frontiers in physiology 2024-10, Vol.15, p.1440307
• Main Authors: Leem, Ah Young, Yu, Hee Tae, Sung, MinDong, Chung, Kyung Soo, Kim, Yeonkyeong, Woo, Ala, Kim, Song Yee, Park, Moo Suk, Kim, Young Sam, Yang, Young Ho, Kim, Ha Eun, Lee, Jin Gu, Kim, Kyuseok, Kim, Kyu Bom, Joung, Boyoung, Park, Junbeom, Lee, Su Hwan
• Format: Article
• Language: English
• Subjects: electrocardiogram; end-stage lung disease; lung transplantation; Physiology; prognosis; risk factor
• ISSN: 1664-042X; 1664-042X
• DOI: 10.3389/fphys.2024.1440307

End-stage lung disease causes cardiac remodeling and induces electrocardiogram (ECG) changes. On the other way, whether lung transplantation (LTx) in end-stage lung disease patients are associated with ECG change is unknown. The object of this study was to investigate ECG changes before and after LTx in end-stage lung disease patients and whether these changes had clinical significance. This was a single-center retrospective cohort study of 280 end-stage lung disease patients who consecutively underwent LTx at a tertiary referral hospital. ECG findings before LTx and within 1 week and 1, 3, and 6 months after LTx were obtained and analyzed. To find clinical meaning, the ECG at 1 month after LTx was analyzed according to 1-year survival (survivor vs non-survivor groups). Survival data were estimated using the Kaplan-Meier method. Significant differences were observed in the PR interval, QRS duration, QT interval, QTc interval, and heart rate before LTx and 1 month after LTx; the PR interval, QRS duration, QTc interval, and heart rate were decreased. Particularly, the QTc interval was significantly decreased 1 month after LTx, whereas there was no significant change in the QTc interval from 1 to 6 months thereafter. The PR interval, QT interval, QTc interval, and heart rate were significantly different between the survivor and non-survivor groups. The serial changes in QTc interval before LTx and 1 and 3 months after LTx were also significantly different between the survivor and non-survivor groups ( = 0.040 after adjusting for age and body mass index). Upon dividing the patients based on the range of QTc interval change ≤ -8 ms, >-8-10 ms, >10-35 ms, >35 ms), the survival rate was significantly lower in the group whose QTc interval at 1 month after LTx decreased by > 35 m ( = 0.019). LTx in patients with end-stage lung disease may induce ECG changes. Patients whose QTc interval at 1 month after LTx decreased by > 35 ms have a significantly higher 1-year mortality rate. Hence, these ECG changes may have clinical and prognostic significance.