Risk factors of electrocardiogram abnormalities in patients with primary liver cancer and its value in predicting prognosis

Objective  To explore the risk factors of electrocardiogram abnormalities in patients with primary liver cancer and its value in predicting prognosis.

Methods  A total of 120 primary liver cancer patients with transcatheter arterial chemoembolization (TACE) were selected as the research objects, and they were divided into abnormal group (n=32) and non-abnormal group (n=88) according to incidence of electrocardiogram abnormalities at 7 days after operation. Baseline data and changes in 24-hour QT interval variability (24-hour QTV), standard deviation of the normal R-R interval from the beginning of atrial depolarization to ventricular depolarization (SDNN), standard deviation of the normal R-R interval for 5 consecutive minutes (SDANN-index), and mean value of the standard deviation of the normal R-R interval for 5 consecutive minutes (SDNN-index) were compared between two groups; a binary Logistic regression model was used to analyze the influencing factors of electrocardiogram abnormalities in patients with primary liver cancer; the receiver operating characteristic (ROC) curve was used to analyze the area under the curve (AUC), sensitivity and specificity of 24 h QTV, SDNN, SDANN-index and SDNN-index in predicting ECG abnormalities in patients with primary liver cancer.

Results  Of the 120 primary liver cancer patients with TACE treatment, 32 cases had electrocardiogram abnormalities, including 13 cases of sinus tachycardia with T-wave changes, 2 cases of ST-T changes, 4 cases of supraventricular tachycardia, 4 cases of QT interval prolongation, 4 cases of ventricular premature beats, and 5 cases of atrial premature beats. There were no significant differences in gender, age, super-selective hepatic artery catheterization, gelatin sponge embolization, use of chemotherapy drugs, postoperative vomiting, and blood uric acid on the third day after surgery between the abnormal group and the non-abnormal group (P>0.05); there were significant differences in tumor diameter, liver function classification, dosage of iodized oil, postoperative body temperature, and blood potassium on the third day after surgery between the two groups (P < 0.05). Logistic regression model showed that tumor diameter ≥10 cm, grade A of liver function classification, iodized oil dose ≥10 mL, postoperative body temperature ≥38 ℃, and decreases of 24 h QTV, SDNN, SDANN-index and SDNN-index were the independent factors affecting electrocardiogram abnormalities in patients with primary liver cancer (P < 0.05). ROC curve analysis showed that the values of AUC of 24 h QTV, SDNN, SDANN-index, SDNN-index and comprehensive electrocardiogram parameters in predicting electrocardiogram abnormalities in patients with primary liver cancer were 0.682, 0.651, 0.632, 0.752 and 0.786 respectively, with statistically significant differences (P < 0.05).

Conclusion  Tumor diameter, liver function classification, dose of iodide oil and postoperative body temperature can affect electrocardiogram abnormalities in patients with primary liver cancer, and electrocardiogram monitoring before and after TACE treatment is conducive to timely detection of electrocardiogram abnormalities.