title: Endothelial dysfunction correlates with liver fibrosis in chronic HCV infection.
abstract: Background. Hepatitis C virus (HCV) infection can exert proatherogenic activities due to its direct action on vessel walls and/or via the chronic inflammatory process involving the liver. Aims. To clarify the role of HCV in atherosclerosis development in monoinfected HCV patients at different degrees of liver fibrosis and with no risk factors for coronary artery disease. Methods. Forty-five patients were included. Clinical, serological, and anthropometric parameters, liver fibrosis (transient liver elastometry (fibroscan) and aspartate aminotransferase to platelet ratio index (APRI)), carotid intima-media thickness (c-IMT), and brachial artery flow-mediated vasodilatation (FMD) were assessed. Patients were divided into 3 tertiles according to fibroscan values. Results. Patients in the third tertile (fibroscan value >11.5 KPa) showed FMD values were significantly lower than second and first tertiles (4.7 ± 1.7% versus 7.1 ± 2.8%, p = 0.03). FMD values were inversely related to liver elastomeric values. c-IMT values were normal. The risk for endothelial dysfunction development in the third tertile (p = 0.02) was 6.9 higher than the first tertile. A fibroscan value >11.5 KPa had a positive predictive power equal to 79% for endothelial dysfunction. Conclusions. HCV advanced liver fibrosis promotes atherosclerosis by inducing endothelial dysfunction independently of common cardiovascular risk factors.
authors.affiliation: Gastroenterology Unit, Department of Medical and Surgical Science, University of Foggia, OO. RR. Foggia, Viale Pinto 1, 71122 Foggia, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Barone
authors.affiliation: Gastroenterology Unit, Department of Emergency and Organ Transplantation, Ospedale Policlinico, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Viggiani
authors.affiliation: Gastroenterology Unit, Department of Medical and Surgical Science, University of Foggia, OO. RR. Foggia, Viale Pinto 1, 71122 Foggia, Italy.
authors.forename: Annabianca
authors.initials: A
authors.lastname: Amoruso
authors.affiliation: Gastroenterology Unit, Department of Emergency and Organ Transplantation, Ospedale Policlinico, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.
authors.forename: Serafina
authors.initials: S
authors.lastname: Schiraldi
authors.affiliation: Cardiology Unit, Department of Emergency and Organ Transplantation, Ospedale Policlinico, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.
authors.forename: Annapaola
authors.identifier: 0000-0003-4819-9971
authors.initials: A
authors.lastname: Zito
authors.affiliation: Cardiology Unit, Department of Emergency and Organ Transplantation, Ospedale Policlinico, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.
authors.forename: Fiorella
authors.initials: F
authors.lastname: Devito
authors.affiliation: Cardiology Unit, Department of Emergency and Organ Transplantation, Ospedale Policlinico, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.
authors.forename: Francesca
authors.identifier: 0000-0002-6899-3366
authors.initials: F
authors.lastname: Cortese
authors.affiliation: Cardiology Unit, Department of Emergency and Organ Transplantation, Ospedale Policlinico, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.
authors.forename: Michele
authors.identifier: 0000-0002-2656-5822
authors.initials: M
authors.lastname: Gesualdo
authors.affiliation: Cardiology Unit, Department of Medical and Surgical Science, University of Foggia, OO. RR. Foggia, Viale Pinto 1, 71122 Foggia, Italy.
authors.forename: Natale
authors.initials: N
authors.lastname: Brunetti
authors.affiliation: Gastroenterology Unit, Department of Emergency and Organ Transplantation, Ospedale Policlinico, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Di Leo
authors.affiliation: Cardiology Unit, Department of Emergency and Organ Transplantation, Ospedale Policlinico, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.
authors.forename: Pietro
authors.identifier: 0000-0003-0471-0053
authors.initials: P
authors.lastname: Scicchitano
authors.affiliation: Cardiology Unit, Department of Emergency and Organ Transplantation, Ospedale Policlinico, University of Bari, Piazza G. Cesare 11, 70124 Bari, Italy.
authors.forename: Marco Matteo
authors.initials: MM
authors.lastname: Ciccone