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Autonomic dysfunction in chronic liver disease

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Abstract

Chronic liver disease is accompanied by a number of circulatory changes including impairment of cardiovascular autonomic reflexes. This occurs irrespective of the aetiology of liver disease, increases in prevalence and severity with worsening hepatic function, and is related at least in part to an autonomic neuropathy. Parasympathetic abnormalities predominate and, although largely subclinical, they may play a role in the altered fluid homeostasis and neurohumoral disturbances associated with cirrhosis. On prospective follow up, the presence of autonomic impairment was associated with a five-fold increased mortality, largely from sepsis and variceal haemorrhage. Defective responses to such stressful events as a result of an afferent defect could possibly explain these findings. Further studies are required to evaluate the natural history of this complication, and determine if it is reversible with improvement in hepatic function or after liver transplantation.

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Author notes

  1. M. T. Hendrickse

    Present address: Department of Medicine, Southmead Hospital, Westbury-on-Trym, BS10 5NB, Bristol, UK

Authors and Affiliations

  1. Department of Medicine and Pharmacology, Royal Hallamshire Hospital, S10 2JF, Sheffield, UK

    M. T. Hendrickse & D. R. Triger

Authors
  1. M. T. Hendrickse
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  2. D. R. Triger
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Additional information

Professor Triger passed away on 13 March 1993. His obituary appears on page 283.

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Hendrickse, M.T., Triger, D.R. Autonomic dysfunction in chronic liver disease. Clinical Autonomic Research 3, 227–231 (1993). https://doi.org/10.1007/BF01829010

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  • DOI: https://doi.org/10.1007/BF01829010

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