Assessment of the left ventricle function using Two-Dimensional Speckle-Tracking Echocardiography among patients with chronic Hepatitis C infection with preserved left ventricle ejection fraction

Background: Subclinical left ventricle dysfunction among patient with chronic hepatitis C is under detected and therefore untreated. The current study aimed to use the Two-Dimensional Speckle tracking echocardiography in the assessment of global and regional function of the left ventricle (LV) myocardium in chronic viral hepatitis C patients with preserved left ventricle ejection fraction (LVEF). Methodology: In this cross-sectional study, 100 participants were divided into 2 groups; 50 patients with chronic hepatitis C and 50 normal healthy matched volunteers as controls. All participants were investigated using conventional echocardiography and 2D speckle tracking. Results: There was no statistically significant difference between hepatitis C group in comparison with control group according to Ejection Fraction (EF%) and fraction shortening (FS) (P= 0.074 and 0.393, respectively). It was be found that 14% of patients suffered from abnormal global longitudinal strain regardless a normal Left ventricular ejection fraction (LVEF). There was significant difference at the level of average GLS (P < 0.001) and as regard regional longitudinal strain, there were significant difference in many segments either basal segments showed in anteroseptal PLSS, inferolateral PLSS, inferior PLSS and infero-septal Peack longitudinal systolic strain (PLSS) (P= 0.012, 0.02, 0.011 and 0.001, respectively). Mid segments in anteroseptal PLSS, anterior PLSS A, anterolateral PLSS A and infero-lateral PLSS A (P= 0.003, 0.011, 0.002 and <0.001, respectively) and Apical segments in anterior PLSS B, lateral PLSS and Septal PLSS (P= 0.013, 0.001 and 0.031, respectively). Conclusion: In chronic hepatitis C patients, left ventricle systolic dysfunction is significantly more common when assessed by global longitudinal strain than by 2D LVEF. To signalize patients with subclinical left ventricle systolic dysfunction irrespective a normal LVEF, 2D STE may be useful for the long-term handling in this high-risk populationm.