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Autonomic function in chronic liver disease assessed by Heart Rate Variability Study
L Coelho1, S Saraiva, H Guimaräes
1Serviços de Gastroenterologia e Cardiologia dos Hospitais da Universidade de Coimbra, Coimbra, Portugal.
Summary
Chronic liver disease significantly impairs autonomic function, as shown by reduced Heart Rate Variability. Liver disease severity directly correlates with the degree of autonomic dysfunction, with indicators of hepatocellular function being more accurate predictors.
Area of Science:
- Cardiology
- Hepatology
- Autonomic Neuroscience
Background:
- Chronic liver disease is linked to cardiovascular changes like hyperdynamic circulation.
- Autonomic dysfunction is implicated in the hyperdynamic state observed in cirrhotic patients.
Purpose of the Study:
- To assess autonomic function in cirrhotic patients using 24-hour Heart Rate Variability (HRV).
- To correlate the extent of autonomic dysfunction with the severity of liver disease.
Main Methods:
- 22 cirrhotic patients and 20 healthy volunteers underwent 24-hour ECG Holter monitoring.
- Heart Rate Variability (HRV) was analyzed in time and frequency domains.
- Patient data included liver disease etiology, Child-Pugh class, and presence of ascites.
Main Results:
- Cirrhotic patients exhibited significantly reduced HRV (SDNN, pNN50) compared to controls.
- Ascites presence was associated with more severe autonomic impairment (lower SDNN).
- Prothrombin activity and serum albumin levels positively correlated with HRV; prothrombin activity was an independent predictor of autonomic dysfunction.
Conclusions:
- Chronic liver disease is characterized by significant Heart Rate Variability reduction.
- Liver disease severity directly impacts the degree of autonomic dysfunction.
- Hepatocellular dysfunction markers are more indicative of autonomic disturbances than cholestasis markers.