Heart rate variability and risk of cardiovascular complications in patients with arterial hypertension and non-alcoholic fatty liver disease


DOI: https://dx.doi.org/10.18565/therapy.2021.2.85-93

Statsenko M.E., Streltsova A.M., Tyschenko I.A., Turovets M.I.

Volgograd State Medical University of the Ministry of Healthcare of Russia
Abstract. Purpose: to study changes in heart rate variability in patients with arterial hypertension (AH) and non-alcoholic fatty liver disease (NAFLD).
Material and methods. A cross-sectional comparative study was conducted. The main group included patients with hypertension and NAFLD (n=50), the control group included patients with isolated AH (n=41). The groups were comparable in terms of the main clinical and demographic indicators (p >0,05).
Results. It was revealed that in patients with AH and NAFLD, compared with patients with isolated AH, the activity of the parasympathetic link of autonomic regulation (RMSSD and pNN50) was significantly lower, and the activity of the sympathetic part of the nervous system was higher. After the orthostatic test, the patients of the main group, as compared to the patients of the control group, had a lower SDNN level (36,0 [26,0; 46,0) vs 38,0 [29,0; 54,0]). In patients with arterial hypertension and NAFLD, compared with patients with arterial hypertension, both the 10-year lethal risk (2,4 [1,4; 5,2] vs 1,1 [0,5; 2,8]; р=0,0006) and the 5-year risk of cardiovascular events (3,0 [1,6; 5,1] vs 1,7 [0,9; 4,4]; р=0,0148) are significantly higher. It was also found that in patients with AH and NAFLD, an increase in the liver steatosis index (FLI) increases the 10-year (r=0,25) and 5-year risk of cardiovascular complications (r=0,20).
Conclusion. In patients with AH and NAFLD, compared with patients with isolated AH, there is a significantly lower activity of the parasympathetic link of autonomic regulation and a shift in the system of regulation of the heart and vascular tone towards sympathicotonia, which increases after the orthostatic test.
Keywords: arterial hypertension, non-alcoholic fatty liver disease, heart rate variability, liver steatosis index, cardiovascular complication
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About the Autors

Mikhail E. Statsenko, MD, professor, head of the Department of internal medicine, Volgograd State Medical University of the Ministry of Healthcare of Russia. Address: 400131, Volgograd, 1 Pavshykh bortsov Sq. Tel.: +7 (8442) 23-86-62. Е-mail: mestatsenko@rambler.ru. ORCID: 0000-0002-3306-0312
Anastasia M. Streltsova, postgraduate student of the Department of internal medicine, Volgograd State Medical University of the Ministry of Healthcare of Russia. Address: 400131, Volgograd, 1 Pavshykh bortsov Sq. Tel.: +7 (8442) 23-86-62. Е-mail: nastyc03@mail.ru. ORCID: 0000-0001-9016-3011
Irina A. Tyschenko, PhD, associate professor of the Department of internal medicine, Volgograd State Medical University of the Ministry of Healthcare of Russia. Address: 400131, Volgograd, 1 Pavshykh bortsov Sq. Tel.: +7 (8442) 97-31-48. Е-mail: tishenco-card@rambler.ru. ORCID: 0000-0002-3046-7264
Mikhail I. Turovets, MD, professor of the Department of anesthesiology and reanimation, transfusiology and emergency medicine, Institute of continuing medical and pharmaceutical education of Volgograd State Medical University of the Ministry of Healthcare of Russia. Address: 400131, Volgograd, 1 Pavshykh bortsov Sq. Tel.: +7 (8442) 58-30-50.
Е-mail: turovets_aro@mail.ru. ORCID: 0000-0003-0793-5098

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