title: Long-term effect of liver transplantation on cirrhotic autonomic cardiac dysfunction.
abstract: There is little information on the long-term effect of liver transplantation (LT) on cardiac autonomic dysfunction in cirrhotic patients. We compared cardiac autonomic function before and in the long-term after LT. In a transversal study, we investigated 30 cirrhotics awaiting LT, 15 clinically stable patients 2-6 years after LT and 27 healthy controls. Seven cirrhotic patients were studied before LT, and 6, 12 and 33 months after LT, in a prospective fashion. Cardiac autonomic function was measured by heart rate variability (HRV) analysis during 24-h electrocardiogram recording. In the transversal study, patients with cirrhosis as compared to healthy controls had significantly reduced standard deviation of normal-to-normal RR intervals (SDNN) (p<0.001) and of the square root of the mean of squared differences between adjacent NN intervals (RMS-SD) (p<0.01), while the ratio between low frequency (LF) and high frequency (HF) at night was significantly (p<0.05) increased. Liver transplanted patients had significantly (p<0.001) higher SDNN values than cirrhotics, while RMS-SD and LF/HF at night did not differ. In the prospective study, SDNN progressively increased after LT and was significantly (p<0.05) higher at 12 and 33 months, compared to the pre-operative value. RMS-SD and LF/HF at night did not change after LT. In conclusion, the overall HRV decrease present in cirrhosis, measured by SDNN values, is partially corrected in the long-term after LT. However, parasympathetic impairment, measured by RMS-SD and LF/HF at night, is not affected even in the long-term after operation.
authors.affiliation: Department of Medicina Clinica Sapienza University, Rome, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Baratta
authors.forename: Luigi
authors.initials: L
authors.lastname: Tubani
authors.forename: Manuela
authors.initials: M
authors.lastname: Merli
authors.forename: Francesca
authors.initials: F
authors.lastname: Labbadia
authors.forename: Donatella
authors.initials: D
authors.lastname: Facchini
authors.forename: Rosanna
authors.initials: R
authors.lastname: De Marco
authors.forename: Massimo
authors.initials: M
authors.lastname: Rossi
authors.forename: Adolfo Francesco
authors.initials: AF
authors.lastname: Attili
authors.forename: Pasquale
authors.initials: P
authors.lastname: Berloco
authors.forename: Stefano
authors.initials: S
authors.lastname: Ginanni Corradini
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology* / Q000503:physiopathology; D016022:Case-Control Studies; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017741:Survivors