| Objective To explore the correlation between liver function, liver fibrosis indexes, liver shear wave elastography (pSWE), liver and biliary ultrasound and their electrocardiogram variants in patients with Wilson’s disease (WD), in order to provide a basis for further research on the mechanism of WD multi-systemic damages and comprehensive clinical diagnosis and treatment. Methods The study cohort comprised 244 patients with Wilson’s disease (WD) admitted to the Affiliated Hospital of Anhui University of Chinese Medicine’s Institute of Neurology between January 1, 2020, and December 31, 2024. Based on pSWE scores, the patients were categorized into the mild fibrosis (n= 73), moderate fibrosis (n=88), and severe fibrosis (n=83) groups. Liver function indicators, serological markers of liver fibrosis (four fibrosis markers), and presence of gallbladder lesions were collected for all three groups. Concurrently, 237 healthy individuals undergoing routine physical examinations at a health screening center were selected as the healthy control group. Electrocardiogram (ECG) parameters were collected for all subjects. Differences in ECG parameters were compared between the healthy control group and the entire WD study group, as well as among the three fibrosis subgroups within the WD group regarding ECG parameters, liver function, liver fibrosis markers, pSWE values, and gallbladder lesion incidence. Based on ECG criteria, WD patients were divided into the ECG-normal and ECG-abnormal groups. Differences in liver function, liver fibrosis markers, pSWE values, and gallbladder lesion incidence were analyzed and compared between these two groups. Spearman correlation analysis was used to evaluate the relationship between the severity of liver fibrosis and all hepatobiliary indicators with ECG parameters. Logistic regression analysis was employed to identify risk factors for cardiac damage in WD patients. Results Compared with the healthy control group, the WD study group exhibited accelerated heart rate, prolonged Q-T interval, QTc interval, and QRS duration, reduced RV5 amplitude, and shortened P-R interval (P<0.05). Intragroup subgroup analysis: As the severity of liver fibrosis progressed in WD patients, indicators including liver function parameters, four markers of liver fibrosis, liver function grading, and incidence of gallbladder lesions progressively deteriorated. Concurrently, heart rate, QT interval, QTc interval, and QRS duration gradually increased (P<0.05). The ECG abnormality group (n=116) exhibited significantly higher levels of TBIL, HA, CⅣ, and pSWE compared to the ECG normality group (n=124) (P <0.05). Spearman correlation analysis revealed that in WD patients, heart rate (r=0.168, P=0.009), Q-T interval (r=0.222, P<0.001), QTc interval (r=0.462, P<0.001), and QRS duration (r=0.202, P=0.002) were positively correlated with the degree of liver fibrosis. Logistic regression results indicated that TBIL (OR=4.911, 95% CI: 1.214~19.858), HA (OR=3.602, 95% CI: 1.015~12.788), and pSWE (OR=3.207, 95% CI: 1.501~6.851) were independent risk factors for ECG abnormalities in WD patients (P<0.05). Conclusion Electrocardiogram abnormalities in WD patients correlate with the degree of liver fibrosis and certain liver and biliary damage markers. Elevated levels of TBIL, HA, and pSWE are independent risk factors for the occurrence of these ECG abnormalities. |
