Heart rate variability in patients with decompensated liver cirrhosis – a pilot study

Introduction: Cirrhosis is associated with many disorders of the cardiovascular system defined "cirrhotic cardiomyopathy". They concern, among others autonomic imbalance. One of the ways to evaluate these disorders is to study the heart rate variability (HRV). Abnormal HRV values occur in hypertension, ischemic heart disease, post myocardial infarction and heart failure. Are one of the prognostic factors.

Aim: Evaluation of parameters of HRV in 24-hour Holter monitoring in patients with decompensated cirrhosis.

Material and methods: The study included 18 patients with decompensated cirrhosis and the control group consisted of 16 healthy subjects. Enrolled were performed 24-hour Holter ECG. Heart rate variability parameters, were estimated during whole recording period, separately for night resting and morning activity hours.

Results: There have been significant differences in almost all, both time and frequency HRV parameters between the two groups for follow-up clock. Similar results were obtained by comparing the HRV separately for the night and morning with a control group. The control group achieved statistically significant differences between all the time parameters of HRV at night compared with morning. Frequency parameters showed no significant differences. In patients with cirrhosis demonstrated such differences for the average time NN, SDNN, SDANN, Tr-I, Tinn and ULF. In a 24-hour observation of HRV parameters did not differ significantly depending on the grade in Child-Pugh classification.

Conclusions: Patients with decompensated cirrhosis showed significantly lower HRV parameters than healthy volunteers. In addition, disturbances of circadian distribution showed these parameters. Disorders of HRV did not correlate with the severity of liver cirrhosis.