title: Assessment of cardiac involvement of hepatitis C virus; tissue Doppler imaging and NTproBNP study.
abstract: BACKGROUND
  Hepatitis C disease burden is substantially increasing in Egyptian community, it is estimated that prevalence of Hepatitis C virus (HCV) in Egyptian community reach 22% of total population. Recently there is a global alert of HCV cardiovascular complications.
  
  
  OBJECTIVE
  To evaluate LV diastolic functions of HCV patients using tissue Doppler Imaging and NTPBNP.
  
  
  METHODS
  30 HCV patients of 30 years, sex & BMI matched controls were evaluated by PCR, ECG, Echocardiography "conventional Doppler, pulsed wave tissue Doppler (PW-TD), strain rate imaging" & NTPBNP to assess LV diastolic functions. Mean age was 32.8 years ± 5.1 in HCV group, 29.8 years ± 6.6 in control group. Cardiovascular anomalies and predisposing factors were excluded.
  
  
  RESULTS
  HCV group has shown significant increase in QTc interval, significant statistical increase in A wave, deceleration time; (p < 0.05), highly significant decrease in tissue Doppler E a (p < 0.001), highly significant decrease in A a (p < 0.001), highly significant increased E/E a ratio (p value < 0.001), significant decrease in E a/A a ratio and significant increase in SRa (p < 0.05). NTPBNP levels showed highly significant increase with mean value 222 pg/ml ± 283 in HCV group and 32.7 pg/ml ± 21.2 in control group (p value < 0.001). The best cut-off value of NTPBNP to detect diastolic dysfunction in HCV group was 213 pg/ml. No statistical differences in SRe/SRa and E/SRe ratios were observed, however they had significant correlation with NTPBNP level and tissue Doppler parameters. The best cut-off value of E/SRe ratio to detect diastolic dysfunction in HCV group was 0.91, with 75% sensitivity and 100% specificity.
  
  
  CONCLUSIONS
  This data show the first direct evidence that HCV infection causes diastolic dysfunction without any other predisposing factors, probably due to chronic inflammatory reaction with mild fibrosis in the heart. Previous studies did not follow strict inclusion and exclusion criteria that confirm the independent role of HCV to cause diastolic dysfunction. Tissue Doppler was more sensitive to diagnose diastolic dysfunction than conventional Doppler.
authors: Academy of Scientific Research and Technology, Cardiovascular and Ultrasonography Research Unit "CURU", Cairo, Egypt.
authors: Ahmed
authors: A
authors: Saleh
authors: Akira
authors: A
authors: Matsumori
authors: Hany
authors: H
authors: Negm
authors: Hany
authors: H
authors: Fouad
authors: Ahmed
authors: A
authors: Onsy
authors: Mohammed
authors: M
authors: Shalaby
authors: Enas
authors: E
authors: Hamdy
keywords: Cardiomyopathy; Diastolic dysfunction; Hepatitis C virus; NTproBNP; Strain rate imaging; Tissue Doppler imaging
references: J Card Fail. 2006 May;12(4):293-8
references: 16679263
references: J Hepatol. 2006 Mar;44(3):455-61
references: 16310281
references: J Rheumatol. 2010 May;37(5):993-9
references: 20194451
references: Scand Cardiovasc J. 2009 Aug;43(4):218-25
references: 19145534
references: Int J Cardiol. 2010 Apr 30;140(3):336-43
references: 19147239
references: J Card Fail. 2000 Sep;6(3):194-200
references: 10997744
references: J Viral Hepat. 2010 Dec;17(12):851-3
references: 20002300
references: Eur J Gastroenterol Hepatol. 2008 Sep;20(9):865-73
references: 18794600
references: J Am Coll Cardiol. 2005 Sep 20;46(6):e1-82
references: 16168273
references: Clin Chem. 2004 Jul;50(7):1174-83
references: 15142976