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Results for “Autonomic dysfunction”

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At least 451 records · Page 25Linked to original sources
PubMed2000

Heart rate variability as a predictor of autonomic dysfunction in patients awaiting liver transplantation.

Chronic liver disease, both alcoholic and nonalcoholic, has been shown to be associated with autonomic neuropathy, as well as other hemodynamic and circulatory disturbances. In a longitudinal study, the presence of autonomic neuropathy and the severity of liver disease were independent risk factors for mortality. The aim of this study was to determine whether the severity of liver disease correlated with measures of heart rate variability. We studied 21 patients being evaluated for liver transplantation to determine if severity of disease correlated with heart rate variability and compared them to seven healthy controls. Heart rate variability was determined for a series of 500 consecutive R-R intervals during quiet breathing. Standard deviation, pNN50, a marker of parasympathetic function, and approximate entropy (ApEn), a recently described measure of regularity, were calculated. Four standard tests of autonomic function were also performed. pNN50 was significantly reduced in all liver disease patients compared to controls (P < 0.05). Both standard deviation and ApEn were significantly reduced in Child's class C patients suggesting a generalized dysfunction in cardiovascular homeostasis. ApEn was significantly lower in the nonsurvivors during follow-up than the survivors (P < 0.05). In conclusion, increasing severity of liver failure is associated with a reduction in total heart rate variability and regularity. Measurement of heart rate variability offers a simple, noninvasive means of assessing the cardiovascular and autonomic effects of liver disease, particularly in those awaiting liver transplantation.

Adult↗
PubMed2004

Cardiovascular autonomic dysfunction correlates with brain MRI lesion load in MS.

OBJECTIVE: The aim of the present study was to investigate the cardiovascular autonomic control in clinically definite multiple sclerosis (MS) patients with a standardised battery of cardiovascular tests and to correlate these findings with the brain magnetic resonance imaging (MRI) lesion load. METHODS: Fifty-one patients with MS and 50 healthy controls were studied. Brain MRI was performed in all patients showing typical MS lesions. The cardiovascular tests were carried out using a standardised battery. RESULTS: Heart rate (HR) responses to deep breathing (P < 0.05) and tilt table testing (P < 0.001) were significantly decreased in MS patients when compared to those of the controls. Blood pressure (BP) responses in the tilt table test were also impaired in MS patients (diastolic P < 0.001, systolic P < 0.05). Of the different brain areas investigated the total volume of the midbrain MRI lesions (P < 0.05) was the one most clearly associated with the impaired BP responses. CONCLUSIONS: MS results in both reduced HR variation and decreased BP reactions indicating disturbed cardiovascular regulation. In particular, the midbrain lesions found in MS are associated with cardiovascular dysfunction.

Adult↗
PubMed2006

A new wrinkle: skin manifestations of aging may relate to autonomic dysfunction.

Various mechanisms have been argued for skin wrinkling, one of the hallmarks of aging. We hypothesize that chronic sympathetic bias is a previously unrecognized mechanism for wrinkling. In the acute setting of water immersion, reversible skin wrinkling is a well-known reflex mediated by the autonomic nervous system. We postulate that skin wrinkling results as a local maladaptive manifestation of a global chronic sympathetic bias that emerges during aging. The persistence of such changes may induce additional compensatory remodeling to cause permanent alteration of the skin. Sympatholytic agents may prove beneficial for arresting or ameliorating the development of wrinkles. Conditions that amplify sympathetic bias such as stress, smoking, amphetamine abuse, HIV, heart failure, and transplantation may accelerate wrinkling. Other common diseases of the skin may also arise as particular manifestations of aberrant autonomic activity through induction of vascular and immune dysfunctions. The temporal and spatial distribution of these dermatologic conditions may reflect variation of autonomic balance, which also regulates T helper immune balance. For all of these dermatologic conditions, local and systemic administration of drugs and medical devices that pharmacologically or electrically modulate autonomic nervous system activity may yield benefits as well.

Aging↗
PubMed1986

Autonomic dysfunction in long-standing alcoholism.

Twenty-eight male alcoholics were studied for peripheral sensory-motor and autonomic neuropathy. The patients were examined neurologically and neurophysiologically after a period of withdrawal treatment in hospital. The function tests of the autonomic nervous system performed were: measurement of the variation of the heart rate at rest and during maximal breathing, Valsalva manoeuvre, postural pulse and blood pressure reactions, and isometric test. Slight abnormalities in the peripheral nervous system were observed in 8 patients, but a frank clinical polyneuropathy supported by neurophysiological findings could be diagnosed only in 2. All of the parameters which reflect the function of the parasympathetic division of the autonomic nervous system were lower in the alcoholics compared with the controls. The most sensitive variables were the heart rate variation at rest, and the postural pulse reaction. The functions mediated by the sympathetic nervous system were not abnormal among this group of alcoholics.

Adult↗
PubMed1981

Child psychiatric problems in "autonomous dysfunction".

The Riley-Day syndrome, also known by the name Familial Dysautonomia, is characterized by a marked deficit in autonomic homeostatic function. A review of the literature and a case illustration describe the physical, emotional, social and learning problems. It is new known that sub-normal intelligence is not part of the syndrome. The impact of the symptoms on the child and on the mother-child relationship may aggravate the deficient emotional balance. Since marked improvement of the condition does occur, especially in patients who reach the age of six, a hopeful attitude in the guidance and treatment is justified and highly beneficial.

Adaptation, Psychological↗
PubMed1993

Autonomic dysfunction in chronic liver disease.

Chronic liver disease is accompanied by a number of circulatory changes including impairment of cardiovascular autonomic reflexes. This occurs irrespective of the aetiology of liver disease, increases in prevalence and severity with worsening hepatic function, and is related at least in part to an autonomic neuropathy. Parasympathetic abnormalities predominate and, although largely subclinical, they may play a role in the altered fluid homeostasis and neurohumoral disturbances associated with cirrhosis. On prospective follow up, the presence of autonomic impairment was associated with a five-fold increased mortality, largely from sepsis and variceal haemorrhage. Defective responses to such stressful events as a result of an afferent defect could possibly explain these findings. Further studies are required to evaluate the natural history of this complication, and determine if it is reversible with improvement in hepatic function or after liver transplantation.

Autonomic Nervous System Diseases↗