Charcteristics of the Autonomic Nervous System in Patients with Liver Cirrhosis and its Dependence on the Severity of Portal Hypertension due to the Values of the Heart Rate Variability Parameters

Introduction. Liver cirrhosis, accompanied by the disorders of all organs and systems, including the autonomic nervous system disorders, which greatly accelerates the negative prognosis, taking part in the pathogenesis of the leading syndrome – portal hypertension, is a major cause of death of the hepatological patients. According to the principles of clinical and experimental approach, recommended by A. M. Wein, exploring the autonomic nervous system, primarily it is important to assess its functional status according to the results of functional and dynamic studies: tone, autonomic reactivity and vegetative support of the body, the first two of which characterize the homeostatic capabilities of the organism, and the last – adaptive. The most informative non-invasive method to evaluate the autonomic nervous system status is the heart rate variability recording. Despite the high prevalence of the autonomic nervous system dysfunction in patients with liver cirrhosis, the condition of the autonomic nervous system in patients with liver cirrhosis and its dependence on the severity of portal hypertension is insufficiently studied, because clinicians often do not pay attention to it, focusing on the deviations of laboratory parameters and severity of liver disease. Therefore, the aim of our study was to describe the state of the autonomic nervous system in patients with liver cirrhosis and determine its dependence on the severity of portal hypertension according to the study of heart rate variability indices. Materials and research methods. Into the study in randomized manner with the preliminary stratification by the presence of liver cirrhosis were involved 240 patients with varying degrees of portal hypertension severity [65 women (27.1 %) and 175 men (72.9 %); aged 21 to 78 years, average age – (48.4 ± 0.8 years)], who were hospitalized with the aim of the examination and treatment into created on the basis of the Internal Medicine Department N 1 of Lviv National Medical University and Gastroenterological Department of Lviv Regional Clinical Hospital, Lviv Regional Hepatological Center. All the patients underwent a comprehensive clinical-laboratory and instrumental examination of all organs and systems, according to the requirements of modern medicine and also, improved by us, ultrasound doppler-floumetric examination of the abdominal cavity vessels, by our patented method, under which all the patients were stratified into three groups: the first group (PH