{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T07:39:11Z","timestamp":1792481951740,"version":"4.5.0"},"reference-count":43,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002873","name":"Chulalongkorn University","doi-asserted-by":"publisher","award":["RA67\/033"],"award-info":[{"award-number":["RA67\/033"]}],"id":[{"id":"10.13039\/501100002873","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with cirrhosis often develop autonomic dysfunction (AD) and endothelial dysfunction (ED), which correlate with higher mortality. Aerobic exercise (AE) is a potential intervention, yet its effects on the autonomic nervous system (ANS) and hemodynamics remain underinvestigated in cirrhosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a parallel\u2010group randomized controlled trial including 50 sedentary patients with compensated cirrhosis. Participants were randomized to a 16\u2010week moderate\u2010intensity AE plus nutritional consultation (AE group;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200925) or nutritional consultation alone (control group, CG;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200925). Outcomes included heart rate variability (HRV), flow\u2010mediated dilation (FMD) for peripheral circulation, mesenteric Doppler ultrasound for splanchnic hemodynamics, and sarcopenia\u2010related outcomes (body composition, handgrip strength dynamometry, and the 6\u2010min walk test [6MWT]). Data were analysed using intention\u2010to\u2010treat (ITT), modified ITT (mITT), and per\u2010protocol approaches, as well as general linear mixed models (LMM).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 50 participants (mean age, 62.6\u2009\u00b1\u20097.0\u2009years; 60% female), 44 participants completed the study. Although most outcomes showed no statistically significant between\u2010group differences, LMM analysis confirmed a significant reduction in the low\u2010frequency to high\u2010frequency (LF\/HF) (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.87,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04), indicating worsening ANS while AE remained stable. Based on mITT analysis, the AE group showed a significant with\u2010in group increase in portal vein volume flow (median \u0394\u2009=\u2009350.66\u2009mL\/min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). Additionally, AE demonstrated significant improvement in 6MWT compared with CG (mean \u0394\u2009=\u200932\u2009m, IQR: 12.00\u201351.60\u2009m,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). No major adverse events occurred.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AE is safe and effectively improves functional capacity in compensated cirrhosis. However, positive signals in autonomic and hepatic parameters were not between\u2010group significant, necessitating a cautious interpretation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70920","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T06:54:49Z","timestamp":1792479289000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of Aerobic Exercise on Autonomic and Endothelial Function and Splanchnic Hemodynamics in Compensated Cirrhosis:\n                    <scp>RCT<\/scp>\n                    Study"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7965-6921","authenticated-orcid":false,"given":"Sirinda","family":"Kittiprachakul","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2002-8429","authenticated-orcid":false,"given":"Sarissa","family":"Rangkla","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onanong","family":"Kulaputana","sequence":"additional","affiliation":[{"name":"Sport and Exercise Medicine Research Laboratory, Department of Physiology, Faculty of Medicine Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1294-7800","authenticated-orcid":false,"given":"Weerapat","family":"Kositanurit","sequence":"additional","affiliation":[{"name":"Sport and Exercise Medicine Research Laboratory, Department of Physiology, Faculty of Medicine Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanat","family":"Tabtieang","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9128-8000","authenticated-orcid":false,"given":"Chanan","family":"Sukprakun","sequence":"additional","affiliation":[{"name":"Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kittigon","family":"Seehaboot","sequence":"additional","affiliation":[{"name":"Excellence Center for Gait and Motion King Chulalongkorn Memorial Hospital, Thai Red Cross Society  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pemika","family":"Woramuksik","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9062-4540","authenticated-orcid":false,"given":"Sompol","family":"Sanguanrungsirikul","sequence":"additional","affiliation":[{"name":"Sport and Exercise Medicine Research Laboratory, Department of Physiology, Faculty of Medicine Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7191-3881","authenticated-orcid":false,"given":"Roongruedee","family":"Chaiteerakij","sequence":"additional","affiliation":[{"name":"Integrated Innovation and Digital Technologies Affairs, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,19]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"5910","DOI":"10.3748\/wjg.v28.i41.5910","article-title":"Epidemiology of Liver Cirrhosis and Associated Complications: Current Knowledge and Future Directions","volume":"28","author":"Liu Y. 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