Heart rate variability in the clinical assessment of patients with chronic liver disease

doi:10.4254/wjh.v17.i7.106291

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World Journal of Hepatology

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World J Hepatol. Jul 27, 2025; 17(7): 106291
Published online Jul 27, 2025. doi: 10.4254/wjh.v17.i7.106291

Heart rate variability in the clinical assessment of patients with chronic liver disease

Abraham IJ Gajardo, Daniela B Vera, Jaime Poniachik, Máximo Cattaneo, Álvaro Urzúa, Christian Lara, Cristóbal Mora, Flavia Giubergia, Nicolás Bustos

Nicolás Bustos, Flavia Giubergia, Cristóbal Mora, Abraham IJ Gajardo, Program of Pathophysiology, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago 8380453, Region Metropolitana, Chile

Christian Lara, Álvaro Urzúa, Máximo Cattaneo, Jaime Poniachik, Daniela B Vera, Section of Gastroenterology, Department of Medicine, Hospital Clínico Universidad de Chile, Santiago 8380456, Region Metropolitana, Chile

Abraham IJ Gajardo, Intensive Care Unit, Department of Medicine, Hospital Clínico Universidad de Chile, Santiago 8380456, Region Metropolitana, Chile

Author contributions: Urzúa A, Cattaneo M, Poniachik J, Vera DB and Gajardo AIJ contributed to the conceptualization and design of this review; Giubergia F, Bustos N, Mora C, Lara C and Gajardo AIJ performed the data/evidence acquisition and interpretation; Cattaneo M, Bustos N, Mora C, Lara C and Gajardo AIJ drafting the manuscript; Urzúa A, Cattaneo M, Poniachik J, Vera DB and Gajardo AIJ critically reviewed the manuscript making significant intellectual contributions. All the authors approved the final version of this manuscript.

Supported by National Agency of Research and Development (ANID), Government of Chile (https://anid.cl/about-us/), through the Initiation in Research FONDECYT grant No. 11241548.

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

Corresponding author: Abraham IJ Gajardo, MD, PhD, Professor, Program of Pathophysiology, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Independencia 1027, Casilla 70058, Santiago 8380453, Region Metropolitana, Chile. aij.gajardo@gmail.com

Received: February 21, 2025
Revised: April 10, 2025
Accepted: June 10, 2025
Published online: July 27, 2025
Processing time: 154 Days and 16.6 Hours

Core Tip

Core Tip: Autonomic dysfunction (AD) is common in cirrhotic patients and is linked to poor outcomes. Heart rate variability (HRV), a noninvasive measure of autonomic balance, could be useful in managing chronic liver disease (CLD) patients. This article explores AD mechanisms, HRV assessment, and its diagnostic, prognostic, and therapeutic relevance in CLD, including liver transplantation.