Autonomic dysfunction in PBC correlates with fatigue severity.

[Guest guest]

Eur J Gastroenterol Hepatol. 2007 Feb;19(2):125-32.

Autonomic

dysfunction in primary biliary cirrhosis correlates with fatigue severity.

Newton JL, son A, Kerr S, Bhala N, Pairman J, Burt J, DE.

Cardiovascular Investigation Unit, University of Newcastle,UK.

BACKGROUND AND

AIMS: Autonomic dysfunction has previously been described in primary biliary

cirrhosis patients. In nonhepatic

diseases, fatigue is associated with autonomic dysfunction and impaired baroreflex sensitivity. Here, we

investigate the prevalence of autonomic dysfunction using highly sensitive

detection modalities and its relationship with fatigue in both noncirrhotic and cirrhotic primary biliary cirrhosis

patients. METHODS: Autonomic reflex tests were

performed, using continuous blood pressure and electrocardiograph measurement

in 47 primary biliary cirrhosis patients and age and sex-matched controls. Fatigue was measured using the primary biliary

cirrhosis-40. RESULTS: In all, 100% of precirrhotic and 81% of cirrhotic primary biliary cirrhosis

patients exhibited autonomic dysfunction. Valsalva ratio and 30 : 15 ratio (measures of

parasympathetic autonomic dysfunction) were significantly lower in primary

biliary cirrhosis patients than in controls (valsalva

ratio: 1.42 vs. 1.57; P=0.01, 30 : 15: 1.1 vs. 1.2; P=0.01). Blood

pressure drop on standing (sympathetic autonomic dysfunction) was greater in

the primary biliary cirrhosis group (31+/-22 vs. 23+/-15 mmHg; P=0.03). Valsalva phase IV size was

similar between primary biliary cirrhosis patients and controls, however, time

to phase IV was significantly longer (P=0.01), suggesting adrenergic failure. Increasing fatigue was associated with impaired baroreflex sensitivity and an earlier, bigger phase IV

(sympathetic overactivity). No

significant differences were seen, between cirrhotic and noncirrhotic

patients. CONCLUSION: The prevalence of autonomic

dysfunction in primary biliary cirrhosis patients is significantly higher than

has previously been thought to be the case. Indeed,

when sensitive detection modalities are used, it is found to be almost

universal at all stages of the disease process. Fatigue

in primary biliary cirrhosis is associated with abnormalities of autonomic

function.

PMID: 17272997 [PubMed - indexed for MEDLINE]

Barb in Texas - Together in the Fight, Whatever it Takes!

Son Ken (33) UC 91 - PSC 99 Listed 7/21 @ Baylor Dallas