title: Functional and morphological myocardial changes in hepatitis C virus patients with end-stage liver disease.
abstract: OBJECTIVE
  Cardiovascular complications are common in liver transplant recipient. This study aims to evaluate functional and morphological myocardial changes in hepatitis C virus (HCV) patients with end-stage liver disease (ESLD) by cardiac magnetic resonance (CMR).
  
  
  METHODS
  This cross-sectional study included 84 patients with HCV-related ESLD. They were subjected to 2D-echocardiography and CMR. The presence, distribution, and percentage of delayed myocardial enhancement (DME) were estimated.
  
  
  RESULTS
  The mean Model for End-Stage Liver Disease score was 21.5 ± 6.3. In CMR, all patients showed good global left ventricular (LV) systolic function (mean ejection fraction = 66.5 ± 8.6%; range: 55-80) with normal wall thickness and motion. Left ventricle was mildly dilated in 25 patients (30%). Grade I and grade II diastolic dysfunction was detected in 81 patients (96.4%) with dilated left atrium in 25 patients (30%). Variable degrees of DME were detected in 70 patients (83.3%) with mean percentage of DME (%DME) being 19.5 ± 16% (range: 4-52). A significant negative correlation was found between %DME and LV ejection fraction (r = -0.7; p < 0.001), cardiac output (r = -0.5; p = 0.013), cardiac index (r = -0.5; p = 0.02), and serum albumin level (r = -0.5; p = 0.01). The %DME ≥19% was associated with 85.7% sensitivity and 85.7% specificity for detection of LV ejection fraction <60% as assessed by echocardiography (area under curve = 0.89; p = 0.001).
  
  
  CONCLUSIONS
  DME with CMR is a common finding among patients with HCV-related ESLD. The extent of DME is significantly associated with global LV systolic function.
authors.affiliation: Endemic Medicine Department , Kasr El Ainy Hospital, Cairo University , Cairo , Egypt.
authors.forename: Dalia A
authors.initials: DA
authors.lastname: Omran
authors.forename: Noha Hosam E L Din
authors.initials: NH
authors.lastname: Behairy
authors.forename: Khaled Serag
authors.initials: KS
authors.lastname: Zakaria
authors.forename: Mohamed Mahmoud
authors.initials: MM
authors.lastname: Nabil
authors.forename: Karim
authors.initials: K
authors.lastname: Said
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004452:Echocardiography / Q000379:methods*; D058625:End Stage Liver Disease / Q000175:diagnosis*; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology*; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology*
keywords: cardiomyopathies; echocardiography; end-stage liver disease; magnetic resonance imaging