Cardiovascular risk assessment by electrocardiographic Holter monitoring in patients with chronic hepatitis C

Abstract

Introduction Cardiovascular diseases are ranked as the third cause of mortality among people infected with hepatitis C virus (HCV), but the relationship of infection with cardiovascular risk remains disputable. We have focused on the comprehensive use of parameters obtainable during long-term electrocardiographic (ECG) Holter monitoring. Material and methods Heart rate variability and turbulence (HRV and HRT), deceleration/acceleration capacity (DC/AC), corrected QT interval (QTc) and late potential (LP) were used. 36 persons were included, and 30 healthy subjects formed a control group. All were submitted to 24-hour Holter ECG-monitoring. Results The studied groups were not statistically significantly different with regards to basic anthropometric parameters. Statistically significantly higher medium and maximum heart rhythm and aminotransferase activities were recorded in patients with hepatitis C. The HRV parameters r-MSSD, p50NN, HF, and absolute DC/AC values were significantly lower in the subjects with hepatitis C than those in the control group. The QTc interval, measured for nocturnal hours, was also significantly longer in that group. There were no differences in the albumin level or basic echocardiographic parameters, including left ventricle ejection fraction. Nor was there any difference in the HRT parameters, or LP. The most interesting observation was the positive correlation among the number of viral RNA copies and DC, and LF. Conclusions We confirmed the presence of autonomic disorders with prevalence of sympathetic system activity and prolonged QTc interval in patients with chronic hepatitis C. Those parameters significantly correlated with infection intensity. Our results suggest that HCV infection could be an independent cardiovascular risk factor, not associated with the lipid profile. Further prospective studies are needed.

The association between hepatitis C virus infection status and blood pressure in adults in the United States: NHANES 1999–2012

“…This metabolic change may affect blood pressure by altering the function and structure of blood vessels ( Wang et al., 2024 ). In addition, a cross-sectional study showed that HCV-infected individuals had a higher 24-hour mean heart rate than non-HCV infection ( Poliwczak et al., 2020 ). Higher heart rate, arteriosclerosis, and vascular sclerosis have been associated with increased DBP ( Koskela et al., 2013 ; Wen et al., 2015 ).…”

Przeszczepienie wątroby u pacjenta z zespołem Budda-Chiariego jako czynnik poprawiający funkcję układu autonomicznego oraz obniżający ryzyko nagłego zgonu sercowego

“…On the other hand, LF has a special predictive value in spectral assessment [3]. Such disorders can be seen in many diseases including the liver: hepatitis C [4], non-alcoholic fatty liver disease [5], primary biliary cirrhosis [6], cirrhosis of the liver in the course of other disorders. The described case shows how the initial disease, which is polycythaemia vera, can lead to a decrease in HRV by inducing BCS and consequently cirrhosis of the liver.…”

The micro-elimination approach - a new way of tackling hepatitis C in paediatric population

“…Consequently, delayed diagnosis could contribute to delayed referrals and treatment which may result in irreversible liver disease (e.g. cirrhosis or hepatocellular carcinoma) and broad spectrum of extrahepatic manifestations [35,41].…”