Viral Load and Genotype Matter in Hepatitis C Virus Related Heart Disease in Cirrhotic Patients

Background: Although the term cirrhotic cardiomyopathy expresses cardiac changes associating liver cirrhosis unrelated to its aetiology, hepatitis C virus HCV was suggested to play a role in cardiomyopathy and/or myocarditis. However the existence of such direct viral effect on the heart in HCV induced liver cirrhosis LC patients remains to be verified. Rationale of the current study was to figure out the influence of the viral load, and genotype in addition to Child Pugh CP score on cardiac structural and functional changes in HCV induced LC patients. Sixty patients were classified according to viral genotype into 4a and non-4a groups. Viral load and the degree of liver impairment according to CP score were also verified in these patients. Data were correlated with echocardiographically assessed left and right sided chambers' structures and functions. Main Results: E/A ratio as an indicator of left ventricular diastolic function showed negative correlation with the viral load and CP score. Ejection fraction of HCV induced LC patients correlated positively with viral load and CP score. Patients who belonged to non-4a genotype group showed significantly larger left ventricular end-diastolic dimensions and left atrial dimensions compared to the 4a group. Right ventricular dimensions correlated positively with CP score. Conclusion: The current study showed that both viral load and genotype had an add-on effect on the expected cirrhotic cardiomyopathic changes in HCV induced LC patients. [Abir Zakaria, Ragai Fouda, Mervate Naguib and Laila Rashed. Viral Load and Genotype Matter in Hepatitis C Virus Related Heart Disease in Cirrhotic Patients] Journal of American Science 2012;8(9):796-803]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 109