The usefulness of heart rate variability linear and non linear parameters in the evaluation of autonomic dysfunction associated with liver cirrhosis

Patients with liver cirrhosis develop autonomic dysfunction, both viral and alcoholic etiology being associated with autonomic imbalance. Holter monitoring of the electrocardiogram is used to evaluate the autonomic dysfunction of the patient through heart rate variability (HRV) analysis. Thirty-five patients with liver cirrhosis, mean age 61.1±8.17 years and female/male ratio 17/18, and a control group were included in the study. Both groups were subject to 24-hour Holter monitoring and comparatively analyzed using linear and non linear parameters of HRV. Our study suggests that in patients with liver cirrhosis linear and non linear HRV parameters extracted from the 2-hours ECG recordings cannot be used as exact predictors of the autonomic dysfunction but a more refined analysis, according to etiology, could offer more significant data. Linear parameters seem to be better indicators of autonomic dysfunction for alcoholic etiology, while non linear parameters and fractal analysis are more significant for hepatitis C virus.