Background : Cirrhosis is associated with a host of hemodynamic, cardiovascular, renal and neurohumoral dysfunction.The relationship between these changes is intriguing and still remains a subject of interest and debate. Objective : The aim of this study to assess the presence of hemodynamic , renal, cardiac structural and functional changes in cirrhosis and the possible relation between sympathetic overactivity and these changes .Methods : Clinical evaluation including heart rate and blood pressure (supine and standing), ECG measurement of the QTc interval, renal function tests, plasma NE and echocardiography (to assess diastolic function).Results :Compared to control, cirrhotic patients had significantly higher resting heart rate and lower MAP in supine position, insignificantly higher HR and significantly lower MAP in the standing position denoting hyperdynamic circulation in supine position.They also showed significantly longer QTc interval than controls. Also they showed significantly higher creatinine and lower serum sodium, creatinine clearance and urinary sodium and significantly higher plasma levels of NE. Echocardiographic assessement revealed significantly greater values of LAD, LVDD, LVPWT and LVWT, increased A wave velocity, increased tdec and reduced E/A ratio. All these finding were more evident in patients with ascites and HRS than patients without ascites.These findings were significantly correlated with the elevated plasma levels of NE.Conclusion: Sympathetic overactivity is related to the presence of hemodynamic, cardiovascular and renal function changes.