title: Autonomic function in cirrhosis assessed by cardiovascular reflex tests and 24-hour heart rate variability.
abstract: OBJECTIVE
  To assess the prevalence of autonomic dysfunction in cirrhosis and to observe the effect of disease severity on autonomic dysfunction.
  
  
  METHODS
  Seventy patients with cirrhosis (Child's class A, 42; Child's class B, 10; and Child's class C, 15) (45 alcoholic, 15 primary biliary cirrhosis, five chronic active hepatitis, and eight idiopathic) underwent standard cardiovascular reflex tests. In addition, in 40 patients, 24-h ECG RR variability tests were performed to detect autonomic dysfunction.
  
  
  RESULTS
  Forty-two of 70 (60%) patients had abnormalities of cardiovascular reflex function of varying severity, whereas 24 of 34 (70%) had 24-h RR counts with the 95% age-related tolerance. The prevalence of abnormality increased with increasing severity of liver disease but not with different etiologies.
  
  
  CONCLUSIONS
  Irrespective of etiology, there is a high prevalence of autonomic dysfunction in cirrhosis, and it is related to disease severity: the mechanism is unknown.
authors.affiliation: Department of Medicine, Royal Infirmary, Edinburgh, Scotland.
authors.forename: J F
authors.initials: JF
authors.lastname: Dillon
authors.forename: J N
authors.initials: JN
authors.lastname: Plevris
authors.forename: J
authors.initials: J
authors.lastname: Nolan
authors.forename: D J
authors.initials: DJ
authors.lastname: Ewing
authors.forename: J M
authors.initials: JM
authors.lastname: Neilson
authors.forename: I A
authors.initials: IA
authors.lastname: Bouchier
authors.forename: P C
authors.initials: PC
authors.lastname: Hayes
mesh_terms: D001342:Autonomic Nervous System Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D001794:Blood Pressure / Q000502:physiology*; D015716:Electrocardiography, Ambulatory; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012021:Reflex, Abnormal / Q000502:physiology*