Electrophysiological parameters in patients with hepatic cirrhosis

Various electrophysiological abnormalities are noted in patients with cirrhosis, the most prevalent consisting of QT prolongation and autonomic dysfunction. This study aims to thoroughly evaluate these abnormalities in cirrhotic patients by utilizing various parameters and compare them with healthy individuals. We evaluated 60 patients with hepatic cirrhosis using a resting electrocardiogram (ECG), ECG during and after the Valsalva maneuver, 24-hour ambulatory ECG monitoring and a standardized ECG stress test. We then compared these results with a group of 50 patients who had no hepatic cirrhosis or other significant known pathologies and were not on any medical treatment. At rest, cirrhotic patients had a reduced Valsalva index compared to the control group, but no statistical differences were noted in comparing resting heart rate (HR) values. At Holter monitoring, although there was a trend toward increased corrected QT (QTc) intervals in cirrhotic patients, it did not reach statistical significance, indicating no difference between the two groups. Reduced standard deviation of normal-to-normal (NN) intervals (SDNN) values, statistically significant, were noted in cirrhotic patients compared to the control group, indicating autonomic dysfunction. At stress test, there was no statistically significant difference in the results obtained for maximum HR during exercise between the two groups. Also, the results showed that cirrhotic patients had statistically significantly higher HR values after exercise compared to the control group. In conclusion, cirrhotic patients presented an increased grade of autonomic dysfunction compared to healthy patients, but no differences were noted regarding QT interval abnormalities.