Mayank Arora1 , Arpit Saini2 , Abhishek Gupta3
BACKGROUND Alcohol consumption is prevalent all over world since ages. In men 40-80 g/d of ethanol produces fatty liver; 160 g/day for 10-20 years causes hepatitis or cirrhosis. Only 15 percent of alcoholics develops alcoholic liver disease. Cirrhosis is the final result of hepatic fibrosis and is reversible in the middle stages of development between fibrogenesis and fibrolysis. This disease leads to hemodynamic disorders that can have widespread impacts in the body according to the severity of the cirrhosis. Autonomic dysfunctions have been observed in patients with chronic liver disease. In most of these cases, autonomic dysfunction has been attributed to an alcohol-mediated neuropathy, but other liver-related mechanisms are conceivable as chronic alcoholics with liver damage have higher frequency of neuropathy than those without it. METHODS The study group consisted of 100 patients, aged 25 - 60 years of age diagnosed with alcoholic liver cirrhosis on the basis of clinical history and laboratory investigations. RESULTS The distribution of age in study population was found to be 41% and 59% in the age group 25-40 and 40-60 years respectively. Among 100 patients recruited for the present study, 71 patients were found to have autonomic dysfunction. The prevalence of autonomic dysfunction was found to be 71% of study population with alcoholic liver cirrhosis. QTc interval was found to be prolonged in cirrhotic patients with autonomic dysfunction as compared to no autonomic dysfunction patients. The abnormality in orthostatic hypotension, HR response to standing and ECG resting tachycardia were found to be statistically significantly associated with Child Pugh Score. CONCLUSIONS Autonomic dysfunction becomes more prominent with the severity of alcoholic liver cirrhosis. Autonomic dysfunction increases the morbidity and mortality among patients with alcoholic liver cirrhosis.
