Abnormalities in the 24‐hour rhythm of skin temperature in cirrhosis: Sleep‐wake and general clinical implications

Garrido, María; Saccardo, Desy; Rui, Michele De; Vettore, Elia; Verardo, Alberto; Carraro, Paolo; Vitofrancesco, Nicola Di; Mani, Ali R.; Angeli, Paolo; Bolognesi, Massimo; Montagnese, Sara

doi:10.1111/liv.13525

Cited by 34 publications

(43 citation statements)

References 38 publications

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“…Additionally, as recent studies have showed thermoregulatory impairment in cirrhotic patients both in skin temperature recordings and core body temperature readings (30,31).…”

Section: Discussionmentioning

confidence: 95%

Which heart rate variability index is an independent predictor of mortality in cirrhosis?

Bhogal

Rui

Pavanello

et al. 2019

Digestive and Liver Disease

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Background: Liver cirrhosis is associated with reduced heart rate variability (HRV), which indicates impaired integrity of cardiovascular control in this patient population. There are several different indices for HRV quantification. The present study was designed to: 1) determine which of the HRV indices is best at predicting mortality in patients with cirrhosis; 2) verify if such ability to predict mortality is independent of the severity of hepatic failure. Methods: Ten minutes electrocardiogram was recorded in 74 patients with cirrhosis. Heart rate fluctuations were quantified using statistical, geometrical and non-linear analysis. The patients were followed-up for 18 months and information was collected on the occurrence of death/liver transplantation. Results: During the follow-up period, 24 patients (32%) died or were transplanted for hepatic decompensation. Cox's regression analysis showed that SDNN (total HRV), cSDNN (corrected SDNN), SD1 (short-term HRV), SD2 (long-terms HRV) and spectral indices could predict survival in these patients. However, only SD2 and cSDNN were shown to be independent of MELD in predicting survival. The prognostic value of HRV indices was independent of age, gender, use of beta blockers, and the aetiology of liver disease. Conclusion: Two HRV indices were identified that could predict mortality in patients with cirrhosis, independently of MELD. These indices are potentially useful tools for survival prediction.

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“…Additionally, as recent studies have showed thermoregulatory impairment in cirrhotic patients both in skin temperature recordings and core body temperature readings (30,31).…”

Section: Discussionmentioning

confidence: 95%

Which heart rate variability index is an independent predictor of mortality in cirrhosis?

Bhogal

Rui

Pavanello

et al. 2019

Digestive and Liver Disease

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“…In addition, there are other markers that can be easily measured and that can reflect circadian phases as well, such as the core body temperature, melatonin, and cortisol secretion (reviewed in Evans & Davidson, 2013). Several recent studies have selected body temperature as a determinant parameter for circadian rhythm evaluation (Garrido et al, 2017;Martinez-Nicolas et al, 2018). Body temperature can be easily measured through wristbands, usually in the non-dominant arm.…”

Section: Monitoring Of Circadian Rhythms In Humansmentioning

confidence: 99%

The importance of determining circadian parameters in pharmacological studies

Gaspar

Álvaro

Carmo‐Silva

et al. 2019

British J Pharmacology

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In mammals, most molecular and cellular processes show circadian changes, leading to daily variations in physiology and ultimately in behaviour. Such daily variations induce a temporal coordination of processes that is essential to ensure homeostasis and health. Thus, it is of no surprise that pharmacokinetics (PK) and pharmacodynamics (PD) of many drugs are also subject to circadian variations, profoundly affecting their efficacy and tolerability. Understanding how circadian rhythms influence drug PK, PD, and toxicity might significantly improve treatment efficacy and decrease related side effects. Therefore, it is essential to take circadian variations into account and to determine circadian parameters in pharmacological studies, especially when drugs have a short half‐life or target rhythmic processes. This review provides an overview of the current knowledge on circadian rhythms and their relevance to the field of pharmacology. Methodologies to evaluate circadian rhythms in vitro, in rodent models and in humans, from experimental to computational approaches, are described and discussed. Lastly, we aim at alerting the scientific, medical, and regulatory communities to the relevance of the physiological time, as a key parameter to be considered when designing pharmacological studies. This will eventually lead to more successful preclinical and clinical trials and pave the way to a more personalized treatment to the benefit of the patients.

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confidence: 99%

Body temperature fluctuation analysis in cirrhosis

Mani

Mazloom

Haddadian

et al. 2017

Liver International

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We recently reported that patients with cirrhosis exhibit an abnormal pattern in their skin temperature variability, with complexity analysis of skin temperature fluctuations distinguishing inpatients from outpatients, despite similar mean temperature values [1]. Patients with cirrhosis also exhibit abnormalities in circadian rhythmicity, part of which are of central origin [2]. Therefore, we wondered if abnormalities in skin temperature fluctuations may reflect abnormalities in core body temperature (CBT) regulation in these patients. To test this hypothesis, we analysed CBT data that we had previously recorded in control rats and rats with cirrhosis [3]. This article is protected by copyright. All rights reserved

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Abnormalities in the 24‐hour rhythm of skin temperature in cirrhosis: Sleep‐wake and general clinical implications

Abstract: Alterations of distal/proximal skin temperature, their gradient and their time-course were observed in patients with cirrhosis, which may contribute to their sleep disturbances.

Cited by 34 publications

References 38 publications

Which heart rate variability index is an independent predictor of mortality in cirrhosis?

Which heart rate variability index is an independent predictor of mortality in cirrhosis?

The importance of determining circadian parameters in pharmacological studies

Body temperature fluctuation analysis in cirrhosis

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