Key result
Nonalcoholic cirrhosis with ascites was associated with impaired autonomic regulation of the heart, including lower LF and higher HF values during the day and reduced QT variability.
Why the study?
Does nonalcoholic cirrhosis with ascites alter autonomic regulation of heart rate and QT interval compared to healthy subjects?
Case-Control (n=24)
Does nonalcoholic cirrhosis with ascites alter autonomic regulation of heart rate and QT interval compared to healthy subjects?
Patients with nonalcoholic cirrhosis and ascites exhibit impaired autonomic regulation of the heart involving both sympathetic and parasympathetic branches, evidenced by altered HRV and QT variability.
Answers are grounded in this paper and cite their sources.
Altered HRV signals autonomic imbalance in ascites cirrhosis; leaves open whether monitoring improves risk stratification or outcomes.
BACKGROUND/AIMS: Autonomic neuropathy, as indicated by alterations in standard cardiovascular tests, is frequently encountered in cirrhosis. We investigated the autonomic modulation of the heart in nonalcoholic cirrhosis with ascites by evaluating the 24-hour heart rate variability (HRV), a powerful noninvasive tool to assess the sympathovagal balance of the heart. METHODS: Low (LF) and high frequency (HF) components and their ratio, and time domain indexes of HRV were evaluated in 24-hour, daytime and nighttime periods in 12 patients and 12 healthy subjects, together with the conventional and dynamic QT interval. RESULTS: Cirrhotic patients had values of the mean RR interval and frequency domain indexes in the whole 24-hour period similar to those of healthy subjects, despite higher than normal plasma norepinephrine levels. Patients also showed lower LF and higher HF values than controls during the day, a reduction in time domain indexes, and no circadian rhythm of frequency domain indexes. QT parameters were similar in the 2 groups, but patients had a blunted QT rhythm and a reduced QT variability. CONCLUSIONS: Patients with nonalcoholic cirrhosis and ascites have an impaired autonomic regulation of the heart, which involves both the sympathetic and the parasympathetic branches of the autonomic nervous system.
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Lazzeri et al. (2009) conducted a case-control in Nonalcoholic cirrhosis with ascites (n=24). Nonalcoholic cirrhosis with ascites vs. Healthy subjects was evaluated on 24-hour heart rate variability (HRV) and QT interval. Nonalcoholic cirrhosis with ascites was associated with impaired autonomic regulation of the heart, including lower LF and higher HF values during the day and reduced QT variability.
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