Autonomic dysfunction is common in liver cirrhosis and is associated with cardiac dysfunction and mortality: prospective observational study

• Published in: São Paulo medical journal 2022-01, Vol.140 (1), p.71-80
• Main Authors: Pimentel, Carolina Frade Magalhães Girardin, Salvadori, Ricardo, Feldner, Ana Cristina de Castro Amaral, Aguiar, Miguel Osman de, Gonzalez, Adriano Miziara, Branco, Gabriel Ribas, Superbia, Marcel, Lai, Michelle, Mota, Daniel de Oliveira, Ferraz, Maria Lucia Cardoso Gomes, Mathias, Wilson, Kondo, Mario
• Format: Article
• Language: English
• Subjects: Autonomic dysfunction; Cirrhotic cardiomyopathy; Heart diseases; Heart rate; Heart rate variability; Liver cirrhosis; MEDICINE, GENERAL & INTERNAL; Mortality; Original
• ISSN: 1516-3180; 1806-9460; 1806-9460
• DOI: 10.1590/1516-3180.2021.0111.R1.18052021

Although autonomic dysfunction has been shown to be associated with liver cirrhosis, the prevalence and prognostic implications are unclear. Abnormal heart rate variability (HRV), a measure of autonomic function, has not been well investigated in cirrhosis. To evaluate the prevalence of high-risk HRV parameters in a cohort of cirrhotic patients and their association with cardiac dysfunction and mortality. Prospective observational study conducted in the Federal University of São Paulo. A cohort of 120 patients, comprising 17 healthy controls and 103 cirrhotic outpatients, was evaluated and followed for 10 months. HRV analysis was based on 24-hour Holter monitoring and defined using time-domain and frequency-domain parameters. The HRV parameters were statistically lower in cirrhotic patients than in healthy subjects. High-risk HRV parameters were prevalent, such that 64% had at least one high-risk parameter. Time-domain parameters correlated with Child scores (P