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Spontaneous baroreflex cardiac sensitivity in end-stage liver disease: effect of liver transplantation

Published online by Cambridge University Press:  01 March 2006

F. Lhuillier ,
E. D. Dalmas ,
P. M. Gratadour ,
A. A. Cividjian ,
O. C. Boillot ,
L. Quintin  and
J. P. Viale
F. Lhuillier
Affiliation:
Hôpital de la Croix-Rousse, Department of Anaesthesia and Intensive Care, Lyon, France
E. D. Dalmas
Affiliation:
Hôpital de la Croix-Rousse, Department of Anaesthesia and Intensive Care, Lyon, France
P. M. Gratadour
Affiliation:
Hôpital de la Croix-Rousse, Department of Anaesthesia and Intensive Care, Lyon, France
A. A. Cividjian
Affiliation:
School of Medicine, Department of Physiology, Lyon, France
O. C. Boillot
Affiliation:
Hôpital E Herriot, Liver Transplantation Unit, Lyon, France
L. Quintin
Affiliation:
School of Medicine, Department of Physiology, Lyon, France
J. P. Viale
Affiliation:
Hôpital de la Croix-Rousse, Department of Anaesthesia and Intensive Care, Lyon, France
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Abstract

Summary

Background and objective: End-stage liver disease is associated with an imbalance in the autonomic nervous system. The purpose of this study was to estimate the effect of liver transplantation on this imbalance. Method: The study involved 10 patients undergoing liver transplantation and 9 patients without liver impairment undergoing liver surgery. The spontaneous baroreflex sensitivity was measured before and 1 month after surgery for the liver surgery group; before and 1, 3, 6, 12 and 18 months after orthotopic liver transplantation. Results: The spontaneous baroreflex slope of patients with end-stage liver disease was decreased before liver transplantation compared to the liver surgery group (3.9 ± 2.5 ms mmHg−1 vs. 9.9 ± 5.0 ms mmHg−1, P = 0.002). The mean slope was significantly increased at 12 and 18 months compared to the pre-transplantation value (3.9 ± 2.5 ms mmHg−1 vs. 8.1 ± 6.6 ms mmHg−1 and 7.4 ± 4.8 ms mmHg−1, respectively; P = 0.042). Nevertheless, further analysis of individual data showed that only four patients exhibited a marked increase in their baroreflex slope 12 months after the liver transplantation whereas it remained decreased in the six others. Conclusions: These results confirm that the baroreflex sensitivity is depressed in end-stage liver disease in line with an autonomic nervous system imbalance. The liver transplantation reverses this disturbance only in some patients.

Keywords

LIVER TRANSPLANTATIONDYSRHYTHMIA SINUSAUTONOMIC NERVOUS SYSTEMBAROREFLEXLIVER DISEASES, chronic
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 5 , May 2006 , pp. 426 - 432
Copyright
2006 European Society of Anaesthesiology

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