The existence of a direct pathogenic link between hepatitis C virus ( HCV ) infection and myocardial injury has not been confirmed. Researchers have investigated the association between myocardial conditions and HCV in patients with HCV-related chronic hepatitis using Thallium-201 myocardial scintigraphy.
In 217 consecutive cases of chronic HCV infection without overt heart disease, Researchers have performed electrocardiography ( ECG ), echocardiography, serum tests on myocardial injury and Thallium-201 myocardial scintigraphy.
Myocardial injury was confirmed by severity score, which was calculated as the sum of Thallium-201 perfusion defect scores. Severity score was followed prior to and after Interferon therapy in 200 patients with chronic hepatitis C.
An abnormal ECG was found in 9% of the patients with chronic hepatitis C. Abnormal severity score was found in 87% of the chronic hepatitis C patients. Independent factors related to higher pretreatment severity score were histology activity index score, serum HCV RNA titer, and indocyanine green disappearance rate.
After Interferon therapy, severity score was improved in patients with sustained virologic response. Among relapsers, severity score improved at the initial disappearance of HCV RNA, but it worsened with the reappearance of HCV RNA.
Severity score in non-viral responders did not change with Interferon therapy.
In conclusion, myocardial perfusion defects were found in 87% of the patients with chronic hepatitis C and improved with viral eradication with Interferon therapy. ( Xagena )
Maruyama S et al, J Hepatol 2013; 58:11-15