Atherosclerosis in chronic hepatitis C virus patients with and without liver cirrhosis

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Barakat A.A.E.-K.; Nasr F.M.; Metwaly A.A.; Morsy S.; Eldamarawy M.

Journal: Egyptian Heart Journal

Publisher: Egyptian Society of Cardiology

Publication Date: June 2017

Volume / Issue: Volume 69 / Issue 2

Pages: 139–147

ISSN: 11102608

DOI: 10.1016/j.ehj.2016.10.004

Scopus: View on Scopus

Document Type: Article

Access: All Open Access; Gold Open Access; Green Open Access

Authors and Affiliations

Barakat A.A.E.-K., Intensive Care Department (ICU), Theodor Bilharz Research Institute (TBRI), Giza, Egypt; Nasr F.M., Intensive Care Department (ICU), Theodor Bilharz Research Institute (TBRI), Giza, Egypt, 15 Wadi Degla Street, Zahraa Al-Maadi, Cairo, Egypt; Metwaly A.A., Intensive Care Department (ICU), Theodor Bilharz Research Institute (TBRI), Giza, Egypt; Morsy S., Gastroenterology and Hepatology Department, Theodor Bilharz Research Institute (TBRI), Giza, Egypt; Eldamarawy M., Intensive Care Department (ICU), Theodor Bilharz Research Institute (TBRI), Giza, Egypt

Abstract

Background Chronic Hepatitis C virus (HCV) infection and liver cirrhosis may be associated with atherosclerosis and coronary artery disease (CAD). There are two phases to atherosclerosis, Subclinical and Clinical. Assessment of atherosclerosis may be started at its Subclinical phase by the evaluation of Epicardial Fat Thickness (EpFT) and Carotid Intima Thickness (CIMT). Aim of the study The aim of the study was to evaluate Clinical and Subclinical atherosclerosis in chronic HCV patients with and without liver cirrhosis by evaluating CIMT and EpFT and correlating the results with Child-Pugh functional scoring of cirrhosis as well as with ultrasound and laboratory parameters that define the severity of liver disease. Patients and methods This study involved 64 chronic HCV patients that were divided into two groups: 24 patients without liver cirrhosis and 40 patients with liver cirrhosis in addition to 20 apparently healthy volunteers serving as control. All of the 84 subjects were subjected to the following: Clinical evaluation; Routine Laboratory Evaluation (CBC, Liver Function Tests, Renal Function Tests, Serum electrolytes, Cholesterol, Triglycerides, HBs antigen and HCV antibody); ECG; Abdominal ultrasound; Echocardiographic evaluation of segmental wall motion abnormalities and EpFT and B-Mode Carotid ultrasonography for evaluation of CIMT. Results In the cirrhotic HCV group, the CIMT and EpFT were both significantly increased [Compared to control group (p = 0.000), compared to the non-cirrhotic HCV group (p = 0.000)]. In the non-cirrhotic HCV group, the CIMT and EpFT were both significantly increased compared to the control group with a p-value of 0.003 for CIMT and 0.048 for EpFT. The CIMT and EpFT were also positively correlated with each other (r = 0.456, p = 0.001). There was a statistically significant increase in the EpFT and CIMT in Child class B patients compared to Child class A (p = 0.007 for CIMT and p = 0.028 for EpFT) and in Child class C patients compared to Child class B patients (p = 0.001 for CIMT and 0.005 for EpFT). CIMT and EpFT were correlated positively with AST (r = 0.385, p = 0.002 for CIMT, and r = 0.379, p = 0.003 for EpFT), Total Bilirubin (r = 0.378, p = 0.003 for CIMT, and r = 0.384, p = 0.002 for EpFT), INR% (r = 0.456, p = 0.001 for CIMT, and r = 0.384, p = 0.001 for EpFT), CRP (r = 0.378, p = 0.003 for CIMT, and r = 0.386, p = 0.002 for EpFT), spleen span (r = 0.417, p = 0.001 for CIMT, and r = 0.437, p = 0.001 for EpFT) and portal Vein Diameter (r = 0.372, p = 0.003 for CIMT, and r = 0.379, p = 0.003 for EpFT). CIMT and EpFT were correlated negatively with Albumin (r = −0.379, p = 0.003 for CIMT, and r = −0.370, p = 0.003 for EpFT), platelets count (r = −0.382, p = 0.002 for CIMT, and r = −0.378, p = 0.003 for EpFT) and Liver Span (r = −0.433, p = 0.001 for CIMT, and r = −0.424, p = 0.001 for EpFT). Conclusion EpFT and CIMT significantly increased in chronic hepatitis C virus patients especially in those with cirrhosis and closely correlated with each other. Their thickness also correlated with the Child-Pugh functional scoring of cirrhosis as well as with ultrasound and laboratory parameters that define the severity of liver disease. The echocardiographic assessment of EpFT and the carotid Doppler assessment of CIMT may provide appropriate and simple screening markers for subclinical atherosclerosis and cardiovascular risk in chronic HCV patients with and without cirrhosis. © 2016 Egyptian Society of Cardiology

Keywords

Carotid intima media thickness; Chronic hepatitis C virus; Epicardial fat thickness; Liver cirrhosis; albumin; bilirubin; C reactive protein; cholesterol; electrolyte; hepatitis B surface antigen; hepatitis C antibody; adult; albumin blood level; arterial wall thickness; Article; atherosclerosis; B scan; bilirubin blood level; Child Pugh score; cholesterol blood level; chronic hepatitis C; clinical evaluation; controlled study; disease severity; electrocardiography; electrolyte blood level; epicardial fat; female; hepatic portal vein; human; international normalized ratio; kidney function test; liver function test; major clinical study; male; spleen size; thickness; thrombocyte count; transthoracic echocardiography; triacylglycerol blood level; vein diameter

Citation Information

Scopus Citations: 10

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