RESUMEN
BACKGROUND: Hepatitis C virus (HCV) infection has been noted with various cardiovascular (CV) diseases, and patients with detected HCV-RNA had higher CV mortality than uninfected individuals. The new direct-acting antiviral drugs (DAA) proved to be more effective with fewer side effects compared to interferon in eradicating HCV, but their effect on myocardium is still questionable. In order to get some answers for such question, two-dimensional speckle tracking echocardiography (2D-STE) was studied before and after treatment with different DAA regimens in HCV patients with either mildly impaired or normal basic left ventricular ejection fraction (LVEF). RESULTS: Global longitudinal strain (GLS) significantly worsened after finishing antiviral treatment in patients with basic impairment of LVEF (n = 100) and those with normal basic LVEF (n = 20) [p = 0.006 and 0.039, respectively]; also, segmental strain showed significant worsening of many segments. Such worsening was significantly more in those with basic impairment of LVEF compared to those with normal basic LVEF (p = 0.036). No significant difference was observed in GLS and segmental strain when classifying and comparing patients according to gender, presence of diabetes mellitus, hypertension, ischemic heart disease and established cardiac medications, or according to DAA regimen received. CONCLUSION: DAA may have a cardiotoxic effect that could be early detected by 2D-STE, which was more significant in patients with pre-treatment impairment of LVEF.
RESUMEN
OBJECTIVES: To investigate the association between 24-hr blood pressure variability (BPV) and subclinical echocardiographic changes and microalbuminuria in normotensive women with history of preeclampsia/eclampsia. BACKGROUND: Ambulatory blood pressure monitoring (ABPM) has been used as a valuable method in determining cardiovascular (CV) risk and target organ damage. Although hypertension and proteinuria that define preeclampsia/eclampsia may resolve in the majority of women, a significantly greater risk of CV and renal disease is present in their later life. METHODS: 101 normotensive women with a past history of preeclampsia/eclampsia and 42 age-matched normal volunteers were subjected to 24-hr ABPM, echocardiography for estimation of left ventricular mass (LVM) index and Aortic distensibility/stiffness indices. Urinary albumin/creatinine ratio was also estimated. RESULTS: There was significantly higher standard deviation (SD) and average reading variability (ARV) indices of BPV in the study group compared to controls (pâ¯<â¯0.001 for all). There were significantly higher LVM index, aortic stiffness index and microalbuminuria in the study group (pâ¯<â¯0.001 for all). There was significant positive correlation between all BPV indices and LVM index, aortic stiffness index (except for SD and ARV of diastolic BP for nighttime) and microalbuminuria. Stepwise regression analysis revealed that ARV of systolic BP for daytime can independently predict LVM index (r2â¯=â¯0.688, pâ¯<â¯0.001), impaired aortic distensibility (r2â¯=â¯0.557, pâ¯<â¯0.001) and microalbuminuria (r2â¯=â¯0.696, pâ¯<â¯0.001). CONCLUSIONS: The BPV indices correlated with subclinical echocardiographic changes and microalbuminuria in normotensive women with history of preeclampsia/eclampsia. The ARV of systolic BP for daytime could early predict such changes in those apparently healthy women.