eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
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5/2020
vol. 16
 
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Cardiology
abstract:
Clinical research

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

Adam Rafał Poliwczak
1
,
Jolanta Białkowska
2
,
Joanna Woźny
2
,
Marzena Koziróg
3
,
Agnieszka Bała
4
,
Maciej Jabłkowski
2

1.
Department of Human Physiology, Medical University of Lodz, Lodz, Poland
2.
Department of Infectious and Liver Diseases, Medical University of Lodz, Lodz, Poland
3.
Department of Internal Diseases and Cardiac Rehabilitation, Medical University of Lodz, Lodz, Poland
4.
Department of Internal Diseases and Clinical Pharmacology, Medical University of Lodz, Lodz, Poland
Arch Med Sci 2020; 16 (5): 1031–1039
Online publish date: 2020/07/15
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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.

keywords:

chronic C hepatitis, cardiovascular risk, ECG Holter

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