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Gîrleanu I, Trifan A, Huiban L, Muzîca C, Petrea OC, Sîngeap AM, Cojocariu C, Chiriac S, Cuciureanu T, Costache II, Stanciu C. Ischemic Heart Disease and Liver Cirrhosis: Adding Insult to Injury. LIFE (BASEL, SWITZERLAND) 2022; 12:life12071036. [PMID: 35888123 PMCID: PMC9315506 DOI: 10.3390/life12071036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 12/13/2022]
Abstract
The link between heart and liver cirrhosis was recognized decades ago, although much data regarding atherosclerosis and ischemic heart disease are still missing. Ischemic heart disease or coronary artery disease (CAD) and liver cirrhosis could be associated with characteristic epidemiological and pathophysiological features. This connection determines increased rates of morbidity and all-cause mortality in patients with liver cirrhosis. In the era of a metabolic syndrome and non-alcoholic fatty liver disease pandemic, primary prevention and early diagnosis of coronary artery disease could improve the prognosis of liver cirrhosis patients. This review outlines a summary of the literature regarding prevalence, risk assessment and medical and interventional treatment options in this particular population. A collaborative heart–liver team-based approach is imperative for critical management decisions for patients with CAD and liver cirrhosis.
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Affiliation(s)
- Irina Gîrleanu
- Depatment of Internal Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iaşi, Romania; (I.G.); (L.H.); (C.M.); (O.C.P.); (A.M.S.); (C.C.); (S.C.); (T.C.); (I.I.C.); (C.S.)
- Institute of Gastroenterology and Hepatology, Saint Spiridon University Hospital, 700115 Iaşi, Romania
| | - Anca Trifan
- Depatment of Internal Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iaşi, Romania; (I.G.); (L.H.); (C.M.); (O.C.P.); (A.M.S.); (C.C.); (S.C.); (T.C.); (I.I.C.); (C.S.)
- Institute of Gastroenterology and Hepatology, Saint Spiridon University Hospital, 700115 Iaşi, Romania
- Correspondence: ; Tel.: +40-762278575
| | - Laura Huiban
- Depatment of Internal Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iaşi, Romania; (I.G.); (L.H.); (C.M.); (O.C.P.); (A.M.S.); (C.C.); (S.C.); (T.C.); (I.I.C.); (C.S.)
- Institute of Gastroenterology and Hepatology, Saint Spiridon University Hospital, 700115 Iaşi, Romania
| | - Cristina Muzîca
- Depatment of Internal Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iaşi, Romania; (I.G.); (L.H.); (C.M.); (O.C.P.); (A.M.S.); (C.C.); (S.C.); (T.C.); (I.I.C.); (C.S.)
- Institute of Gastroenterology and Hepatology, Saint Spiridon University Hospital, 700115 Iaşi, Romania
| | - Oana Cristina Petrea
- Depatment of Internal Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iaşi, Romania; (I.G.); (L.H.); (C.M.); (O.C.P.); (A.M.S.); (C.C.); (S.C.); (T.C.); (I.I.C.); (C.S.)
- Institute of Gastroenterology and Hepatology, Saint Spiridon University Hospital, 700115 Iaşi, Romania
| | - Ana Maria Sîngeap
- Depatment of Internal Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iaşi, Romania; (I.G.); (L.H.); (C.M.); (O.C.P.); (A.M.S.); (C.C.); (S.C.); (T.C.); (I.I.C.); (C.S.)
- Institute of Gastroenterology and Hepatology, Saint Spiridon University Hospital, 700115 Iaşi, Romania
| | - Camelia Cojocariu
- Depatment of Internal Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iaşi, Romania; (I.G.); (L.H.); (C.M.); (O.C.P.); (A.M.S.); (C.C.); (S.C.); (T.C.); (I.I.C.); (C.S.)
- Institute of Gastroenterology and Hepatology, Saint Spiridon University Hospital, 700115 Iaşi, Romania
| | - Stefan Chiriac
- Depatment of Internal Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iaşi, Romania; (I.G.); (L.H.); (C.M.); (O.C.P.); (A.M.S.); (C.C.); (S.C.); (T.C.); (I.I.C.); (C.S.)
- Institute of Gastroenterology and Hepatology, Saint Spiridon University Hospital, 700115 Iaşi, Romania
| | - Tudor Cuciureanu
- Depatment of Internal Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iaşi, Romania; (I.G.); (L.H.); (C.M.); (O.C.P.); (A.M.S.); (C.C.); (S.C.); (T.C.); (I.I.C.); (C.S.)
- Institute of Gastroenterology and Hepatology, Saint Spiridon University Hospital, 700115 Iaşi, Romania
| | - Irina Iuliana Costache
- Depatment of Internal Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iaşi, Romania; (I.G.); (L.H.); (C.M.); (O.C.P.); (A.M.S.); (C.C.); (S.C.); (T.C.); (I.I.C.); (C.S.)
- Cardiology Department, Saint Spiridon University Hospital, 700115 Iaşi, Romania
| | - Carol Stanciu
- Depatment of Internal Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iaşi, Romania; (I.G.); (L.H.); (C.M.); (O.C.P.); (A.M.S.); (C.C.); (S.C.); (T.C.); (I.I.C.); (C.S.)
- Institute of Gastroenterology and Hepatology, Saint Spiridon University Hospital, 700115 Iaşi, Romania
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Poliwczak AR, Białkowska J, Woźny J, Koziróg M, Bała A, Jabłkowski M. Cardiovascular risk assessment by electrocardiographic Holter monitoring in patients with chronic hepatitis C. Arch Med Sci 2020; 16:1031-1039. [PMID: 32863991 PMCID: PMC7444696 DOI: 10.5114/aoms.2020.96600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 03/05/2018] [Indexed: 11/17/2022] Open
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.
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Affiliation(s)
- Adam R. Poliwczak
- Department of Human Physiology, Medical University of Lodz, Lodz, Poland
| | - Jolanta Białkowska
- Department of Infectious and Liver Diseases, Medical University of Lodz, Lodz, Poland
| | - Joanna Woźny
- Department of Infectious and Liver Diseases, Medical University of Lodz, Lodz, Poland
| | - Marzena Koziróg
- Department of Internal Diseases and Cardiac Rehabilitation, Medical University of Lodz, Lodz, Poland
| | - Agnieszka Bała
- Department of Internal Diseases and Clinical Pharmacology, Medical University of Lodz, Lodz, Poland
| | - Maciej Jabłkowski
- Department of Infectious and Liver Diseases, Medical University of Lodz, Lodz, Poland
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Fukuda R, Kondo Y. Hepatitis C virus infection could affect the pathogenesis of ischemic heart diseases in northern Japan. Hepatol Res 2019; 49:355-359. [PMID: 30375711 DOI: 10.1111/hepr.13283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 10/22/2018] [Accepted: 10/26/2018] [Indexed: 12/14/2022]
Abstract
AIMS Previously, our group reported that lymphotropic hepatitis C virus (HCV) could induce various kinds of immune dysfunctions. The immune dysfunctions could cause vascular disease by inducing cryoglobulinemia. It has been reported that ischemic heart diseases might be caused by HCV. However, the infectious rate of HCV in patients with ischemic heart disease has not been clarified in northern Japan. Therefore, we tried to determine the rate of HCV infectivity in patients with ischemic heart disease. METHODS The target patients of this study were automatically selected using an electronic medical record system to exclude selection bias. The system identified 16 484 patients with ischemic heart disease who were included in this study. In addition, 12 902 subjects who had received medical checkups were included as the control group. RESULTS The positive rate of HCV antibody among the patients with ischemic disease in our hospital was 2.58%, which was significantly higher (P < 0.01) than in the medical checkup patients (0.84%). The positive rate of HCV antibody in the patients with ischemic heart disease in each age group was significantly higher than in the corresponding age groups of the medical checkup patients. The rate of chronic kidney disease in HCV antibody-positive patients treated by percutaneous coronary intervention (PCI) was significantly higher than in HCV antibody-negative patients treated by PCI (P = 0.02). CONCLUSIONS Hepatitis C virus infection might be associated with the pathogenesis of ischemic heart disease and HCV antibody positivity might be a risk factor for ischemic heart disease in northern Japan.
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Affiliation(s)
- Ryo Fukuda
- Department of Hepatology, Sendai Kousei Hospital, Sendai, Japan.,Treatment Center for Liver Cancer, Sendai Kousei Hospital, Sendai, Japan
| | - Yasuteru Kondo
- Department of Hepatology, Sendai Kousei Hospital, Sendai, Japan.,Treatment Center for Liver Cancer, Sendai Kousei Hospital, Sendai, Japan
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