Autonomic Neuropathy in Liver Cirrhosis: Prevalence and Association with Clinical and Laboratory Features
An impaired autonomic nervous system activity has been described in liver cirrhosis (1,2). Namely, an enhanced sympatho-adrenergic activity has been found in patients with ascites, who also showed an impaired cardiovascular responsiveness to such an adrenergic hypertone (2). Moreover, in these patients the cardiovascular response to the administration of exogenous norepinephrine (1), as well as maneuvers stimulating the adrenergic activity (3), was impaired. Recently, abnormalities of vagal activity have also been described and related to the alcoholic etiology of liver disease (4). It has been suggested that vagal neuropathy may result in an inappropriate, non osmotic secretion of antidiuretic hormone, promoting the appearance of hyponatremia (4), an abnormality which is frequently detectable in advanced liver failure.
KeywordsUpright Posture Blood Pressure Response Autonomic Nervous System Activity Hand Grip Test Deep Breathing Test
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