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Changes in cardiovagal baroreflex sensitivity are related to increased ventricular mass in patients with liver

Jun-Gol Song1, Young-Kug Kim, Won-Jung Shin

  • 1Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Circulation Journal : Official Journal of the Japanese Circulation Society
|September 15, 2012
PubMed

Insights

Reduced cardiovagal baroreflex sensitivity (BRS) is linked to increased left ventricular mass in liver cirrhosis patients. This suggests BRS impacts cardiac remodeling and heart function in cirrhotic cardiomyopathy.

Area of Science:

  • Cardiology
  • Gastroenterology
  • Physiology

Background:

  • Liver cirrhosis (LC) is associated with cardiac changes due to neurohumoral activation and hyperdynamic circulation.
  • Cardiovagal baroreflex sensitivity (BRS) inversely correlates with left ventricular (LV) morphology.
  • Hypothesis: Reduced BRS in cirrhotic cardiomyopathy is linked to myocardial remodeling and increased LV mass index (LVMI).

Purpose of the Study:

  • To investigate the association between cardiovagal BRS and myocardial remodeling in patients with liver cirrhosis.
  • To determine if reduced BRS correlates with increased LV mass index (LVMI) in cirrhotic cardiomyopathy.

Main Methods:

  • Eighty-two liver transplant candidates with LC were assessed.
  • Beat-by-beat blood pressure and heart rate (HR) time series analyzed using spectral analysis to derive BRS.
  • Echocardiography evaluated cardiac morphology and function before transplantation.

Main Results:

  • BRS showed inverse correlations with LV wall thickness, interventricular septum thickness, LVMI, and HR.
  • LVMI and HR were independently associated with BRS on multivariate analysis.
  • Patients in the highest LVMI tertile exhibited significantly impaired BRS compared to those in the lowest tertile.

Conclusions:

  • Reduced cardiovagal BRS is associated with increased LV mass in liver cirrhosis patients.
  • This finding suggests a link between cardiovagal BRS, heart rate control, and cardiac end-organ damage in cirrhotic cardiomyopathy.
Abstract

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