Elsevier

Journal of Hepatology

Volume 22, Issue 3, March 1995, Pages 326-332
Journal of Hepatology

Exercise-induced left ventricular dysfunction in alcoholic and non-alcoholic cirrhosis

https://doi.org/10.1016/0168-8278(95)80286-XGet rights and content

Abstract

Background/Aims: Autonomic and cardiac dysfunction have been reported in patients with cirrhosis. We studied left ventricular and autonomic function in 20 patients with both alcoholic and non-alcoholic cirrhosis.

Methods: Autonomic function was assessed by a standard battery of cardiovascular reflex tests. Supine exercise radionuclide ventriculography was used to assess the cardiac response to exercise.

Results: Exercise capacity was reduced in all patients in association with marked chronotropic incompetence (peak heart rates 120.5±6 bpm). Unlike normal subjects thee was no increase in left ventricular ejection fraction on exercise. Stroke volume increased by 23±6%, mediated by an increase in end-diastolic volume of >20%. Cardiac output was subnormal at maximal exercise, increasing by only 96±14% and 97±11% in alcoholic and non-alcoholic groups respectively. The majority (83%) of our patients had autonomic reflex abnormalities.

Conclusions: Patients with cirrhosis of alcohol and non-alcohol related aetiologies have significantly impaired cardiovascular responses to exercise, which are similar to those of a denervated heart. This may have important clinical implications for the ability of these patients to withstand cardiovascular stress.

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