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Evaluation of cardiac function by global longitudinal strain before and after treatment with sofosbuvir-based

Maria Mazzitelli1, Carlo Torti2, Jolanda Sabatino3

  • 1Unit of Infectious and Tropical Diseases, Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Viale Europa, 88100, Catanzaro, Italy.

BMC Infectious Diseases
|October 18, 2018
PubMed

Insights

Hepatitis C treatment with sofosbuvir-based regimens may worsen heart function, as measured by global longitudinal strain (GLS). Further research is needed to confirm clinical significance and the safety of these direct-acting antiviral (DAA) treatments.

Area of Science:

  • Cardiology
  • Hepatology
  • Pharmacology

Background:

  • Hepatitis C virus (HCV) infection can negatively impact cardiac function.
  • The potential cardiotoxicity of sofosbuvir, a direct-acting antiviral (DAA), remains unconfirmed in humans.
  • Assessing left ventricular function using global longitudinal strain (GLS) offers greater sensitivity than ejection fraction (EF).

Purpose of the Study:

  • To evaluate the impact of HCV treatment with DAAs, including sofosbuvir, on left ventricular function.
  • To determine if HCV eradication confers cardiac benefits using GLS.
  • To investigate potential cardiotoxicity associated with sofosbuvir-based therapies.

Main Methods:

  • Prospective study involving 82 patients undergoing HCV treatment with DAAs.
  • Transthoracic cardiac ultrasound performed at four time points: baseline, 1 month, end of treatment, and 6 months post-treatment.
  • Left ventricular function assessed using both ejection fraction (EF) and global longitudinal strain (GLS).

Main Results:

  • A statistically significant worsening trend in global longitudinal strain (GLS) was observed post-HCV treatment.
  • No significant variations were found in ejection fraction (EF) during the follow-up period.
  • The decline in GLS remained statistically significant after adjusting for body mass index and liver fibrosis, irrespective of treatment duration.

Conclusions:

  • HCV treatment with direct-acting antivirals, including sofosbuvir, was unexpectedly associated with a worsening of left ventricular function as measured by GLS.
  • While the observed GLS changes were statistically significant, their clinical significance requires further investigation.
  • The safety profile of sofosbuvir-based regimens warrants continued and thorough study.
Abstract

Keywords:
Cardiac functionDAA treatmentHCV eradicationLongitudinal study

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