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Autonomic dysfunction in chronic liver disease

M T Hendrickse1, D R Triger

  • 1Department of Medicine and Pharmacology, Royal Hallamshire Hospital, Sheffield, UK.

Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society
|August 1, 1993
PubMed
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Chronic liver disease impairs cardiovascular autonomic reflexes, particularly parasympathetic function, increasing mortality risk. This autonomic neuropathy worsens with liver disease severity and may be linked to sepsis and bleeding complications.

Area of Science:

  • Cardiology
  • Hepatology
  • Neurology

Background:

  • Chronic liver disease (CLD) is associated with significant circulatory alterations.
  • Cardiovascular autonomic reflex dysfunction is a common complication of CLD, irrespective of its cause.
  • Autonomic neuropathy, predominantly affecting the parasympathetic system, contributes to altered fluid balance and neurohumoral disturbances in cirrhosis.

Purpose of the Study:

  • To investigate the prevalence and impact of autonomic dysfunction in patients with chronic liver disease.
  • To determine the relationship between the severity of hepatic dysfunction and autonomic impairment.
  • To assess the prognostic significance of autonomic neuropathy in CLD.

Main Methods:

  • Prospective follow-up study design.

Related Experiment Videos

  • Assessment of cardiovascular autonomic reflexes in patients with CLD.
  • Correlation analysis between autonomic function, hepatic function, and clinical outcomes.

    • Main Results:

    • Autonomic impairment was observed in patients with CLD, worsening with reduced hepatic function.
    • Parasympathetic abnormalities were predominant.
    • Autonomic dysfunction was associated with a five-fold increase in mortality, primarily due to sepsis and variceal hemorrhage.

    Conclusions:

    • Autonomic neuropathy is a significant complication of chronic liver disease with profound prognostic implications.
    • Impaired autonomic responses may contribute to adverse outcomes like sepsis and bleeding.
    • Further research is needed to explore reversibility with improved liver function or transplantation.