Evaluation of Cardiovascular Autonomic Dysfunction in Chronic Viral Hepatitis in untreated patients

Abstract

background: The autonomic nervous system plays a major role in the regulation of the cardiovascular system under both physiological and pathological conditions, Subclinical autonomic dysfunction can, however, occur within a year of diagnosis, and impaired autonomic function has been described in patients with chronic liver diseases from different etiologies, the chronic viral hepatitis (CVH) is the principal cause of chronic liver disease. Patients with CVH have many extrahepatic manifestations, and even with no clear evidence of autonomic nervous system dysfunction. Consequently, the purpose of this study/ to evaluate the cardiovascular autonomic dysfunction in such patients. Method: Sixty two CVH patients include in this study, (36 patients have CVH B and 26 patients have CVHC), compared with thirty normal, healthy control group in analysis of heart rate, including heart rate in postural change, in deep breathing and valsalva maneuver, and the parameter of blood pressure in the supine position, response to postural change, isometric handgrip.Result: The results point out to both parasympathetic and sympathetic efferent fibers modulates cardiovascular function is affected, it has been found cardiac autonomic dysfunction in analysis of results recorded in 55.56% of CVHB patients from these percentage 50% patients had subclinical cardiac autonomic dysfunction and 50% had mild clinical cardiovascular autonomic dysfunction, while the CVHC patients 69.23% had cardiovascular autonomic dysfunction, from these percentage 44.44% patients had subclinical cardiac autonomic dysfunction, and 55,56% had mild clinical cardiovascular autonomic dysfunction.Conclusion: The cardiovascular autonomic neuropathy recorded in patients with CVH, remains mild clinical or subclinical and explained by autonomic function tests.Keywords: ANS; autonomic nervous system, CVAFT; cardiovascular cardiac autonomic function test, CVH; chronic viral hepatitis, CVHB; chronic viral hepatitis B, CVHC; chronic viral hepatitis C.