Assessment of Autonomic Nervous Activity in Chronic Liver Disease

Study of autonomic nervous system activity in chronic liver disease has aroused great interests due to its increasing prevalence due to various etiologies. The present study was undertaken to assess the autonomic nervous system activity in chronic liver disease patients by five standard autonomic function tests. Forty patients (20 with alcoholic liver disease and 20 with nonalcoholic liver disease) and 40 normal healthy age sex matched controls were recruited in the study. Statistical analysis comprised student’s “t” test. Thirty out of the 40 patients (75%) were found to have autonomic dysfunction. Fourteen out of 30 patients (46.67%) had only parasympathetic damage and 16 out of 30 (53.53%) had combined sympathetic and parasympathetic damage. Eighty percent of the alcoholic liver disease patients and 70 % of the nonalcoholic liver disease patients showed autonomic dysfunction. In conclusion, autonomic nervous dysfunction is present in significant number of patients with chronic liver disease. Overall; the parasympathetic impairment was more frequently present in chronic liver disease patients than sympathetic impairment . Autonomic dysfunction is found with comparable frequency in alcoholics and non-alcoholics suggesting that chronic liver disease, irrespective of etiology, contributes to autonomic dysfunction. The clinical implication of our study is that keeping in view the significant prevalence of autonomic dysfunction caution should be exercised while managing chronic liver disease patients as cirrhotic cardiomyopathy can be unmasked by surgical intervention.