Alteration of cardiovascular autonomic activity in patients of alcoholic liver disease in North-East India: a hospital based study
DOI:
https://doi.org/10.18203/2320-6012.ijrms20162951Keywords:
Alcoholic liver disease, Cardiovascular autonomic neuropathy, Sympathetic, ParasympatheticAbstract
Background: In the present day world, alcohol consumption is one of the most common and serious public health problems. Alcoholism is a major risk factor for quite a large number of health complications, cardiovascular autonomic dysfunction being one of them. Sudden death in alcoholic liver disease (ALD) patients may be due to undiagnosed and untreated cardiovascular autonomic neuropathy.
Methods: Five standard cardiovascular autonomic function tests were performed to assess the autonomic reactivity in 60 alcoholic liver disease patients at a tertiary care hospital in North-East India and the results were compared with that of 40 ages and sex matched healthy controls.
Results: Out of the 60 ALD patients, 17 (i.e. 28%) have early parasympathetic damage (early PS damage), 25 (i.e., 42%) have definite parasympathetic damage and 18 (i.e. 30%) have a combined type of autonomic damage.
Conclusions: The most affected function in our study is the heart rate response to lying to standing, 40% of the cases showed abnormal 30:15 ratio. Similarly, Blood pressure response to Handgrip test was found to be the least affected one with abnormality percentage of 13%. Present study did not find any pure sympathetic abnormality.
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References
Gururaj G, Pratima Murthy, Girish N & Benegal V. Alcohol related harm: Implications for public health and policy in India, Publication No. 73, NIMHANS, Bangalore, India. 2011.
Barter F, Tanner AR. Autonomic neuropathy in an alcoholic population. Postgrad Med J. 1987;63(746):1033-6.
Ewing DJ, Clarke BF. Diagnosis and management of diabetic autonomic neuropathy. Br Med J (Clin Res Ed). 1982;285(6346):916-8.
Ravaglia S, Marchioni E, Costa A, Maurelli M, Moglia A. Erectile impotence as a sentinel symptom for cardiovascular autonomic neuropathy in heavy- drinkers. J Peripheral Nervous system. 2004;9(4):209-14.
Dillon JF, Plevris JN, Nolan J, Ewing DJ, Neilson JM, Bouchier IA, et al. Autonomic functions in cirrhosis assessed by cardiovascular reflex tests and 24-hr heart rate variability. Am J Gastroenterol. 1994;89(9):1544-7.
Bajaj BK, Agarwal MP, Ram BK. Autonomic neuropathy in patients with hepatic cirrhosis. Postgrad Med J. 2003;79(933):408-11.
Singh G, Singh K, Manchanda KC, Sharma RS. Assessment of Autonomic Nervous Activity in Chronic Liver Disease. Biomedical Research. 2011;22(1):85-9.
Jain J, Banait S, Singh R, Udan V, Rao T. Magnitude and pattern of Autonomic neuropathy in Cirrhosis of Liver: A cross- sectional study from Central rural India. J Mahatma Gandhi Institute of Med Sci. 2015;20(1):66-73.