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Exercise-induced left ventricular dysfunction in alcoholic and non-alcoholic cirrhosis
R D Grose1, J Nolan, J F Dillon
1Department of Medicine, Royal Infirmary of Edinburgh, Scotland, UK.
Journal of Hepatology
|March 1, 1995
Summary
Patients with cirrhosis exhibit impaired cardiac and autonomic function, leading to reduced exercise capacity and abnormal heart responses. This cardiovascular dysfunction, seen in both alcoholic and non-alcoholic cirrhosis, may impact their ability to handle stress.
Area of Science:
- Cardiology
- Hepatology
- Autonomic Neuroscience
Background:
- Cirrhosis is associated with autonomic and cardiac dysfunction.
- Investigating these dysfunctions in both alcoholic and non-alcoholic cirrhosis is crucial.
Purpose of the Study:
- To assess left ventricular and autonomic function in patients with cirrhosis.
- To compare cardiovascular responses to exercise in patients with alcoholic vs. non-alcoholic cirrhosis.
Main Methods:
- Cardiovascular reflex tests were used to evaluate autonomic function.
- Radionuclide ventriculography assessed cardiac response during exercise.
- 20 patients with alcoholic and non-alcoholic cirrhosis were studied.
Main Results:
- Reduced exercise capacity and chronotropic incompetence were observed in all patients.
- Left ventricular ejection fraction did not increase with exercise, unlike in healthy individuals.
- Cardiac output was subnormal during maximal exercise, with 83% showing autonomic reflex abnormalities.
Conclusions:
- Patients with cirrhosis, regardless of etiology, have impaired cardiovascular responses to exercise.
- These responses resemble those of a denervated heart.
- This dysfunction has clinical implications for managing cardiovascular stress in cirrhosis patients.