The Efficacy of Aerobic Exercise Training on Autonomic Nervous System and Endothelial Function in Patients With Compensated Cirrhosis
The goal of this clinical trial is to explore the impact of a 16-week aerobic exercise regimen on the autonomic nervous system and endothelial function in patients with compensated cirrhosis who maintain sedentary lifestyles. The primary research question is:

1) What effect does 16 weeks of aerobic exercise have on changes in the autonomic nervous system and endothelial function in cirrhotic patients?

Additionally, the secondary research questions are:

How does a 16-week aerobic exercise program influence changes in muscle mass, muscle strength, and physical performance in cirrhotic patients?
Is there a correlation between muscle mass and parameters of the autonomic nervous system in cirrhotic patients?

Participants in the intervention group will undergo 150 minutes of moderate aerobic exercise per week for 16 weeks, accompanied by a personalized nutritional plan (1.2 grams of protein per kilogram of ideal body weight per day and a calorie intake of 35 kilocalories per kilogram of ideal body weight per day). The control group will solely receive nutritional guidance and maintain their sedentary lifestyle. The researchers will compare outcomes between these two groups.
- EligibilityCriteria: Inclusion Criteria:  The diagnosis of cirrhosis is confirmed either through liver biopsy or the presence of portal hypertension, evidenced by esophageal varices on endoscopy, ascites, and/or compatible features on ultrasonography. The age range is between 45 and 75 years. Participants are classified as Child Pugh score class A. Participants report a sedentary lifestyle, defined as engaging in physical activity for less than 150 minutes of moderate-intensity physical activity per week, or less than 75 minutes of vigorous-intensity physical activity per week, or an equivalent combination of both.  Exclusion Criteria:  Active hepatocellular carcinoma (HCC) or remission of HCC within the past 3 months. Untreated large esophageal varices (EV) greater than F2 or history of upper gastrointestinal bleeding from portal hypertension or gastric varices. Active or history of hepatic encephalopathy (HE). Inpatient hospitalization for any reason or discharge from the hospital within the past 3 months. Complete portal vein thrombosis. Transjugular intrahepatic portosystemic shunt. Contraindications to exercise, such as recent myocardial infarction, unstable angina, electrocardiography changes within the past 24 hours, complete heart block, acute congestive heart failure, uncontrolled hypertension, hemoglobin level less than 11 g/dL, platelet count less than 50,000 cells/mm 3 . Use of Vitamin E and C supplements. End-stage renal disease without dialysis. Severe orthopedic problems that limit the ability to exercise. Inability to communicate with the research team via telemedicine system. Body mass index (BMI) exceeding 30 kg/m 2 . - HealthyVolunteers: No - Gender: All - MinimumAge: 45 Years - MaximumAge: 75 Years - StdAgeList: Adult, Older Adult