{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:22:14Z","timestamp":1787764934858,"version":"build-2784847793"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Heart rate variability (HRV) is the variation in the time intervals between continuous heartbeats also called interbeat intervals to give information related to the heart, blood pressure, gaseous exchange, and sympathetic and parasympathetic balance. Abnormalities in the conduction of the cardiac system alter the measurements of heart rate variability and lead to alteration in autonomic function with a higher risk of mortality. So, our objective includes the assessment of sympathovagal balance in AFLD and NAFLD patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MATERIALS AND METHODS:<\/jats:title>\n                    <jats:p>The study included 78 alcoholic and 54 nonalcoholic fatty liver patients. A room temperature of 23\u00b0C with 25\u201335% humidity will be maintained in a recording room. Basal supine heart rate and BP will be recorded by the oscillometric method using an automated blood pressure monitor Omron MX3, India. Lead II ECG will be recorded for the next 5 minutes in total resting condition for short-term HRV analysis. Short-term HRV indices including time domain and frequency domain were recorded from each patient. Under time domain, SDNN, RMSSD, and average RR were noted. Under frequency domain, LF, HF, VLF, LF (nu), HF (nu), and LF\/HF were calculated. The data were collected by using a 16-bit, power lab 8\/30 data acquisition system (New South Wales, Australia) with acknowledge 3.8.2 software. Inferential analyses such as independent t-tests and Mann\u2013Whitney tests were used to compare NAFLD and AFLD patient groups. Carl Pearson correlation analysis was performed to obtain a relationship between variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>SDNN in (ms) which represents the overall HRV found to be decreased in both alcoholic (32.84 \u00b1 79.08) and nonalcoholic fatty liver disease (22.04 \u00b1 13.85) compared to the normal range (50 \u00b1 16)) from 27 studies. The value of RMSSD in (ms) was decreased in both alcoholic (17.00 \u00b1 12.48) and nonalcoholic fatty liver disease patients (14.00 \u00b1 9.44) with the normal range of (42 \u00b1 15) from 15 studies. Pearson correlation analysis showed the age of AFLD patients significantly and positively correlated with average RR. Pearson correlation analysis for the age of NAFLD patients was significantly and positively correlated with the average RR, HF, SDNN, RMSSD, and LF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>Altered autonomic activity was noted in both alcoholic and nonalcoholic fatty liver disease patients. An early prognosis of fatty liver is very necessary to prevent the disease progress into later fatal life-threatening stages.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jehp.jehp_449_23","type":"journal-article","created":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T09:04:34Z","timestamp":1701335074000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Assessment of sympathovagal balance by HRV analysis in alcoholic and nonalcoholic fatty liver disease patients"],"prefix":"10.4103","volume":"12","author":[{"given":"Divyashree N.","family":"Uchil","sequence":"first","affiliation":[{"name":"Department of Physiology Yenepoya Deemed to be University, Mangalore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. S","family":"Moosabba","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Yenepoya Deemed to be University, Mangalore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Kalpana","sequence":"additional","affiliation":[{"name":"Department of Physiology Yenepoya Deemed to be University, Mangalore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Grrishma","sequence":"additional","affiliation":[{"name":"Department of Physiology Yenepoya Deemed to be University, Mangalore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,11]]},"reference":[{"key":"R1-20240829","doi-asserted-by":"crossref","first-page":"258","DOI":"10.3389\/fpubh.2017.00258","article-title":"An overview of heart rate variability metrics and norms","volume":"5","author":"Shaffer","year":"2017","journal-title":"Front Public Health"},{"key":"R2-20240829","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s40101-021-00272-y","article-title":"Assessment of autonomic function by long-term heart rate variability: Beyond the classical framework of LF and HF measurements","volume":"40","author":"Hayano","year":"2021","journal-title":"J Physiol Anthropol"},{"key":"R3-20240829","doi-asserted-by":"crossref","first-page":"26","DOI":"10.4103\/jehp.jehp_222_19","article-title":"Cognition, autonomic function, and intellectual outcomes of the paramedical health-care personnel in the hospital settings","volume":"9","author":"Rao","year":"2020","journal-title":"J Educ Health Promot"},{"issue":"11","key":"R4-20240829","article-title":"Fatty liver disease in-depth analysis","volume":"5","author":"Anvith","year":"2015","journal-title":"Am J Pharm Res"},{"key":"R5-20240829","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1002\/kjm2.12390","article-title":"Astragal side alleviates alcoholic fatty liver disease by suppressing oxidative stress","volume":"37","author":"Jiang","year":"2021","journal-title":"Kaohsiung J Med Sci"},{"key":"R6-20240829","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1002\/hep.22350","article-title":"Visceral fat: A key mediator of steatohepatitis in metabolic liver disease","volume":"48","author":"Van der Poorten","year":"2008","journal-title":"Hepatology"},{"key":"R7-20240829","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12902-022-00980-1","article-title":"Non-alcoholic fatty liver disease (NAFLD): A review of pathophysiology, clinical management, and effects of weight loss","volume":"22","author":"Pouwels","year":"2022","journal-title":"BMC Endocr Disord"},{"key":"R8-20240829","doi-asserted-by":"crossref","first-page":"47","DOI":"10.4103\/jehp.jehp_512_21","article-title":"A comparative study on the health-promoting behaviors of patients with and without hypertensive heart disease in Iran","volume":"11","author":"Baharvand","year":"2022","journal-title":"J Educ Health Promot"},{"key":"R9-20240829","doi-asserted-by":"crossref","first-page":"1482","DOI":"10.3389\/fendo.2021.752944","article-title":"Autonomic imbalance increases the risk for non-alcoholic fatty liver disease","volume":"12","author":"Jung","year":"2021","journal-title":"Front Endocrinol"},{"key":"R10-20240829","first-page":"106","article-title":"A comparative study of cardiovascular autonomic function in patients with alcoholic-fatty liver disease and non-alcoholic fatty liver disease","volume":"42","author":"Laishram","year":"2022","journal-title":"Biomedicine"},{"key":"R11-20240829","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.ejim.2015.02.009","article-title":"Heart rate and cardiovascular protection","volume":"26","author":"Caetano","year":"2015","journal-title":"Eur J Internal Med"},{"key":"R12-20240829","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1038\/s41598-022-05037-w","article-title":"Low heart rate variability from 10-s electrocardiograms is associated with the development of non-alcoholic fatty liver disease","volume":"12","author":"Choi","year":"2022","journal-title":"Sci Rep"},{"key":"R13-20240829","doi-asserted-by":"crossref","first-page":"217","DOI":"10.4103\/jehp.jehp_627_19","article-title":"Depression affects the autonomic system of the body? Yes, it does","volume":"9","author":"Singla","year":"2020","journal-title":"J Educ Health Promot"},{"key":"R14-20240829","doi-asserted-by":"crossref","first-page":"5160754","DOI":"10.1155\/2016\/5160754","article-title":"Cardiovascular autonomic dysfunction in patients of nonalcoholic fatty liver disease","volume":"2016","author":"Kumar","year":"2016","journal-title":"Int J Hepatol"},{"key":"R15-20240829","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1016\/j.jhep.2019.08.018","article-title":"The risk of incident extrahepatic cancers is higher in non-alcoholic fatty liver disease than obesity\u2013A longitudinal cohort study","volume":"71","author":"Allen","year":"2019","journal-title":"J Hepatol"},{"key":"R16-20240829","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1002\/hep4.1419","article-title":"Mortality related to nonalcoholic fatty liver disease is increasing in the United States","volume":"3","author":"Paik","year":"2019","journal-title":"Hepatol Commun"},{"key":"R17-20240829","doi-asserted-by":"crossref","first-page":"530","DOI":"10.3889\/oamjms.2020.4319","article-title":"Nonalcoholic fatty liver disease, and the risk of atrial fibrillation","volume":"8","author":"Abou Omar","year":"2020","journal-title":"Open Access Maced J Med Sci"},{"key":"R18-20240829","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1093\/qjmed\/hcv006","article-title":"Association between non-alcoholic fatty liver disease and autonomic dysfunction in a Chinese population","volume":"108","author":"Sun","year":"2015","journal-title":"QJM"},{"key":"R19-20240829","doi-asserted-by":"crossref","first-page":"e0163044","DOI":"10.1371\/journal.pone.0163044","article-title":"Timing and type of alcohol consumption and the metabolic syndrome-ELSA-Brazil","volume":"11","author":"Vieira","year":"2016","journal-title":"PloS One"},{"key":"R20-20240829","doi-asserted-by":"crossref","first-page":"4150","DOI":"10.18203\/2320-6012.ijrms20162951","article-title":"Alteration of cardiovascular autonomic activity in patients of alcoholic liver disease in North-East India: A hospital-based study","volume":"4","author":"Deka","year":"2016","journal-title":"Int J Res Med Sci"}],"container-title":["Journal of Education and Health Promotion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jehp.jehp_449_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:51:58Z","timestamp":1787763118000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jehp.jehp_449_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11]]},"references-count":20,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/jehp.jehp_449_23","relation":{},"ISSN":["2277-9531"],"issn-type":[{"value":"2277-9531","type":"print"}],"subject":[],"published":{"date-parts":[[2023,11]]},"assertion":[{"value":"2023-04-01","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-02","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}