HEART RATE VARIABILITY IN PATIENTS WITH LIVER CIRRHOSIS – A MARKER FOR AUTONOMIC DISFUNCTION

Authors: Robert D. NEGRU, Doina-Clementina COJOCARU, Anca TRIFAN, Corina DIMA-COZMA

Abstract:

The study aimed at evaluating the potential correlations between heart rate variability (HRV) parameters and liver cirrhosis severity and etiology, and at estimating the type of autonomic disfunction induced, over a 24 hour Holter monitoring.
Methods. Included in the study were 48 patients with liver cirrhosis and 30 control subjects, submitted to a 24-hour ECG recording, whose time and frequency domain HRV parameters were analyzed.
Results. The imbalance between the two autonomic components was reflected in significantly lower values recorded for the time-domain parameters (mean RR, SDNN, SDNN index and SDANN index), LF (P = 0.02) and LF/HF ratio (P < 0.001) in cirrhosis versus controls, except for HF, r-MSSD and pNN50, which suggests a markedly decreased sympathetic activity, with the vagal component less impaired. Alcoholic etiology recorded the most important impairment of HRV parameters. Conclusions. The 24-hour ECG monitoring of HRV parameters could help in establishing the noninvasive prognostic markers in patients with liver cirrhosis.