Skin temperature variability is an independent predictor of survival in patients with cirrhosis

Bottaro, Matteo; Abid, Noor-Ul-Hoda; El-Azizi, Ilias; Hallett, Joseph W.; Koranteng, Anita; Formentin, Chiara; Montagnese, Sara; Mani, Ali R.

doi:10.14814/phy2.14452

Cited by 9 publications

(17 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Such a difference between acute MI and cirrhosis has also been shown in studies where non-linear measures of HRV were used for determination of prognosis (Tapanainen et al, 2002;Bottaro et al, 2020). It appears that short-term fractal scaling (α1) of HRV is a powerful predictor of mortality among patients surviving an acute myocardial infarction while only long-term fractal scaling (α2) predicts mortality in patients with cirrhosis (Tapanainen et al, 2002;Bottaro et al, 2020). Based on these reports, it is not surprising to observe that prognostic models that have been developed for acute MI may not be applicable to cirrhosis.…”

Section: Discussionmentioning

confidence: 60%

“…Ethics approval for the main study ( Bottaro et al, 2020 ) was obtained from the University of Padova Ethics Committee (4169/AO/17). Written informed consent was provided by all patient involved and data was collected and stored appropriately.…”

Section: Methodsmentioning

confidence: 99%

“…We have recently investigated the prognostic value of physio-markers (e.g., conventional HRV indices and body temperature variability) in a cohort of patients with cirrhosis ( Bottaro et al, 2020 ). However, it rapidly became apparent to us that, most patients exhibit PVCs in their 24-h ECG recording.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Heart Rate Turbulence Predicts Survival Independently From Severity of Liver Dysfunction in Patients With Cirrhosis

Oyelade¹,

Canciani

Bottaro

et al. 2020

Front. Physiol.

Self Cite

View full text Add to dashboard Cite

BackgroundReduced heart rate variability (HRV) is an independent predictor of mortality in patients with cirrhosis. However, conventional HRV indices can only be interpreted in individuals with normal sinus rhythm. In patients with recurrent premature ventricular complexes (PVCs), the predictive capacity of conventional HRV indices is compromised. Heart Rate Turbulence (HRT) represents the biphasic change of the heart rate after PVCs. This study was aimed to define whether HRT parameters could predict mortality in cirrhotic patients.Materials and Methods24 h electrocardiogram recordings were collected from 40 cirrhotic patients. Turbulence Onset was calculated as HRT indices. The enrolled patients were followed up for 12 months after the recruitment in relation to survival and/or transplantation.ResultsDuring the follow-up period, 21 patients (52.5%) survived, 12 patients (30%) died and 7 patients (17.5%) had liver transplantation. Turbulence Onset was found to be strongly linked with mortality on Cox regression (Hazard ratio = 1.351, p < 0.05). Moreover, Turbulence Onset predicted mortality independently of MELD and Child-Pugh’s Score.ConclusionThis study provides further evidence of autonomic dysfunction in cirrhosis and suggests that HRT is reliable alternative to HRV in patients with PVCs.

show abstract

Section: Discussionmentioning

confidence: 60%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Heart Rate Turbulence Predicts Survival Independently From Severity of Liver Dysfunction in Patients With Cirrhosis

Oyelade¹,

Canciani

Bottaro

et al. 2020

Front. Physiol.

Self Cite

View full text Add to dashboard Cite

show abstract

“…Further models using a network approach should include more physiological data, such as heart rate variability and temperature variability indices. Reduced heart rate variability and body temperature variability are known to be inversely associated with increased mortality in cirrhosis patients, where their prognostic value is independent of MELD or Pugh scores (Mani et al, 2009;Bhogal et al, 2019;Bottaro et al, 2020). In a subset of patients investigated, the uncoupling of the autonomic nervous system and cardiovascular system was found to be associated with mortality in liver cirrhosis patients.…”

Section: Discussionmentioning

confidence: 93%

Organ System Network Disruption Is Associated With Poor Prognosis in Patients With Chronic Liver Failure

2020

Self Cite

View full text Add to dashboard Cite

Background: A healthy individual has a high degree of functional connectivity between organ systems, which can be represented graphically in a network map. Disruption of this system connectivity is associated with mortality in life-threatening acute illnesses, demonstrated by a network approach. However, this approach has not been applied to chronic multisystem diseases and may be more reliable than conventional individual organ prognostic scoring methods. Cirrhosis is a chronic disease of the liver with multisystem involvement. Development of an efficient model for prediction of mortality in cirrhosis requires a profound understanding of the pathophysiologic processes that lead to poor prognosis. In the present study, we use a network approach to evaluate the differences in organ system connectivity between survivors and non-survivors in a group of well-characterized patients with cirrhosis. Methods: 201 patients with cirrhosis originally referred to the Clinic five at the University Hospital of Padova, with 13 clinical variables available representing hepatic, metabolic, haematopoietic, immune, neural and renal organ systems were retrospectively enrolled and followed up for 3, 6, and 12 months. Software was designed to compute the correlation network maps of organ system interaction in survivors and non-survivors using analysis indices: A. Bonferroni corrected Pearson's correlation coefficient and B. Mutual Information. Network structure was quantitatively evaluated using the measures of edges, average degree of connectivity and closeness, and qualitatively using clinical significance. Pair-matching was also implemented as a further step after initial general analysis to control for sample size and Model for End-Stage Liver Disease (MELD-Na) score between the groups. Results: There was a higher number of significant correlations in survivors, as indicated by both the analysis indices of Bonferroni corrected Pearson's correlation coefficient and the Mutual Information analysis. The number of edges, average degree of connectivity and closeness were significantly higher in survivors compared to non-survivors group. Pair-matching for MELD-Na was also associated with increased connectivity in survivors compared to non-survivors over 3 and 6 months follow up. Conclusion: This study demonstrates the application of a network approach in evaluating functional connectivity of organ systems in liver cirrhosis, demonstrating a

show abstract

“…In the present study, we determined a cut-off value for TO for prediction of mortality in cirrhosis and did not report our results based on previously reported cut-off values (e.g., 0% for TO and 2.5 ms/R-R for TS) and categories of HRT (0-1-2) which were originally shown to be predictive for mortality in patients with acute myocardial infarction (MI) (Schmidt et al, 1999;Ghuran et al, 2002;Bauer et al, 2008). Although both acute MI and cirrhosis exhibit autonomic dysfunction, distinctive components of autonomic function appears to be involved in these two illnesses (Tapanainen et al, 2002;Bottaro et al, 2020). Following acute MI, both TO and TS can predict mortality (Schmidt et al, 1999;Ghuran et al, 2002).…”

Section: Discussionmentioning

confidence: 89%

Table_6.DOCX

View full text Add to dashboard Cite

Skin temperature variability is an independent predictor of survival in patients with cirrhosis

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 9 publications

References 54 publications

Heart Rate Turbulence Predicts Survival Independently From Severity of Liver Dysfunction in Patients With Cirrhosis

Heart Rate Turbulence Predicts Survival Independently From Severity of Liver Dysfunction in Patients With Cirrhosis

Organ System Network Disruption Is Associated With Poor Prognosis in Patients With Chronic Liver Failure

Table_6.DOCX

Contact Info

Product

Resources

About