Abstract
BackgroundHepatitis C virus (HCV) infection has been noted with various cardiovascular (CV) diseases, and patients with detected HCV-RNA had higher CV mortality than uninfected individuals. The new direct-acting antiviral drugs (DAA) proved to be more effective with fewer side effects compared to interferon in eradicating HCV, but their effect on myocardium is still questionable. In order to get some answers for such question, two-dimensional speckle tracking echocardiography (2D-STE) was studied before and after treatment with different DAA regimens in HCV patients with either mildly impaired or normal basic left ventricular ejection fraction (LVEF).ResultsGlobal longitudinal strain (GLS) significantly worsened after finishing antiviral treatment in patients with basic impairment of LVEF (n = 100) and those with normal basic LVEF (n = 20) [p = 0.006 and 0.039, respectively]; also, segmental strain showed significant worsening of many segments. Such worsening was significantly more in those with basic impairment of LVEF compared to those with normal basic LVEF (p = 0.036). No significant difference was observed in GLS and segmental strain when classifying and comparing patients according to gender, presence of diabetes mellitus, hypertension, ischemic heart disease and established cardiac medications, or according to DAA regimen received.ConclusionDAA may have a cardiotoxic effect that could be early detected by 2D-STE, which was more significant in patients with pre-treatment impairment of LVEF.
Highlights
Hepatitis C virus (HCV) infection has been noted with various cardiovascular (CV) diseases, and patients with detected HCV-ribonucleic acid (RNA) had higher CV mortality than uninfected individuals
We evaluated the effect of different Direct-acting antiviral drugs (DAA) regimens on myocardial function in chronic viral hepatitis C patients with either mildly impaired or normal pretreatment left ventricular ejection fraction (LVEF) using Two-dimensional speckle tracking echocardiography (2D-speckle tracking echocardiography (STE))
From the 153 recruited patients, 120 patients were included (33 patients were excluded: 4 patients had atrial fibrillation (AF) and 1 patient developed a new AF during the treatment course, patients had pretreatment LVEF < 40%, 7 patients stopped treatment due to noncardiac causes, and patients were missed during the study course)
Summary
Hepatitis C virus (HCV) infection has been noted with various cardiovascular (CV) diseases, and patients with detected HCV-RNA had higher CV mortality than uninfected individuals. In order to get some answers for such question, twodimensional speckle tracking echocardiography (2D-STE) was studied before and after treatment with different DAA regimens in HCV patients with either mildly impaired or normal basic left ventricular ejection fraction (LVEF). Hepatitis C virus (HCV) infection is a serious health problem in many developing African and Asian countries, with the highest prevalence in Egypt, mostly due to the previous mass parenteral anti-schistosomal treatments [1]. We evaluated the effect of different DAA regimens on myocardial function in chronic viral hepatitis C patients with either mildly impaired or normal pretreatment left ventricular ejection fraction (LVEF) using 2D-STE Two-dimensional (2D) speckle tracking echocardiography (STE) is a promising modern cardiac imaging (2021) 73:6 modality that provides an important estimation of both systolic and diastolic function, ischemic myocardial affection, and many other pathophysiological processes, through calculating myocardial velocities and deformation parameters such as strain and strain rate [6].
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