Prevalence of autonomic dysfunction in cirrhotic and noncirrhotic portal hypertension

The American Journal of Gastroenterology
M RangariShiv Kumar Sarin

Abstract

Autonomic dysfunction is common in patients with cirrhosis of the liver, but more so in patients with decompensated state, and is associated with increased mortality. We evaluated the presence and extent of autonomic dysfunction in patients with extrahepatic portal venous obstruction (EHPVO) and noncirrhotic portal fibrosis (NCPF), diseases with relatively preserved liver functions. Heart rate variability in response to standing, deep breathing, and Valsalva maneuver and blood pressure response to sustained handgrip and standing were studied in 18 patients with EHPVO (13 mol/L, 5 F, mean age 15.2 +/- 6 yr), 12 patients with NCPF (5 mol/L, 7 F, mean age 26.4 +/- 8 yr), 15 patients with cirrhosis (7 mol/L, 8 F, mean age 12.6 +/- 6 yr), and 17 healthy controls (11 mol/L, 6 F, mean age 18.6 +/- 3 yr). Time-domain parameters of heart rate variability on 24-h ambulatory monitoring were assessed in all the patients. Autonomic dysfunction was observed in 67% of EHPVO, 25% of NCPF, and 80% of cirrhotic subjects but none of the healthy controls (p < 0.05). Four of five time-domain heart rate variability indices showed significant abnormalities in patients with EHPVO (p < 0.05) and cirrhosis (p < 0.05), when compared with patients with NC...Continue Reading

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Citations

Sep 1, 2007·Hepatology International·Shiv Kumar SarinUNKNOWN Members of the APASL Working Party on Portal Hypertension
Feb 14, 2007·Journal of Gastroenterology and Hepatology·Jacob AlexanderPrabha Sawant
Feb 29, 2008·BMC Gastroenterology·Agostino Di CiaulaPiero Portincasa
Dec 11, 2002·Journal of Gastroenterology and Hepatology·S K Sarin
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Oct 18, 2005·Seminars in Pediatric Surgery·Frédéric Gauthier
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Apr 1, 2014·Clinics in Liver Disease·Shiv K Sarin, Rajeev Khanna
Sep 8, 2010·The American Journal of Gastroenterology·Puneeta TandonJaime Bosch
Jan 26, 2018·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Akash ShuklaS J Bhatia
Feb 1, 2008·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Elizabeth J CareyDavid D Douglas
Sep 10, 2010·European Journal of Gastroenterology & Hepatology·Aravindh SomasundaramVenkataraman Jayanthi
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Oct 30, 2018·Journal of the American Heart Association·William A HuangMarmar Vaseghi
Feb 21, 2006·World Journal of Gastroenterology : WJG·Soren Moller, Jens H Henriksen

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