A recent study has found that the relationship between inflammation and heart rhythm stability is influenced by various factors, depending on whether a patient has coronary disease or cirrhosis.
The predictive power of key inflammatory markers, such as C-reactive protein, differs significantly depending on the specific condition a patient is suffering from. This was discovered in a new study published in the Bulgarian Society of Medical Sciences Journal.
Electrocardiograms are used to measure ventricular repolarization, which refers to the time it takes for the heart muscle to reset after each beat. This is considered an essential indicator of heart health stability. The main factors that affect this electrical function are the pumping ability of the left ventricle and activity of the autonomic nervous system.Inflammatory diseases like liver failure or coronary blockage can disrupt these factors and led to increased inflammation.
contrasting Inflammation and Heart Rhythm instability Across Diseases
This study aimed to compare how inflammation affects heart rhythm instability in different diseases localized in different systems.
“Most studies on markers of inflammation come from patients with cardiovascular diseases like coronary artery disease,” explains Dr. Niya Emilova from University Emergency Medicine Hospital Pirogov in Sofia, Bulgaria who led this research project.
The researchers measured three primary inflammation markers: white blood cell count, C-reactive protein, and procalcitonin. White blood cell count refers to the number of infection-fighting cells in the body,while C-reactive protein is produced in response to systemic inflammation. Procalcitonin is a highly specific indicator of bacterial infection.
Their paper titled “C-reactive protein is closely related to cardiac repolarization in patients with coronary artery disease in contrast to patients with cirrhosis” reveals that C-reactive protein is associated with an increased risk of ventricular arrhythmias in stable coronary disease. In contrast, both C-reactive protein and white blood cell count were found to be correlated with repolarization indices in acute myocardial infarction.
In cirrhosis patients, only high white blood cell counts showed a trend for linking to unstable heart rhythms. Interestingly, C-reactive protein did not correlate with heart rhythms in this group.
“White blood cell counts and procalcitonin levels are associated with an increased risk of complications in alcoholic cirrhosis. In patients receiving treatment for cirrhosis and infection, high white blood cell counts are a specific marker for increased dispersion of repolarization,” write the researchers.
Implications for Treatment
The study suggests that certain medications used to treat heart failure and coronary disease may have preventive value by reducing the risk of life-threatening cardiac arrhythmias in patients with cirrhosis.
Original source:
Emilova N, Dineva D, Moneva-Sakelarieva M, Kobakova Y, Chaneva M, Ionchev I, Slaveva D, Popova M, Tododrov R, Kostov K, Sarakostova S (2026) C-reactive protein and cardiac repolarization in cirrhosis. Bulgarian Society of Medical Sciences Journal 8: e154296. https://doi.org/10.3897/bsms.8.154296
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This is a fascinating study comparing two different patient populations. I’m excited to see the results!