The online version of this article (https://doi.org/10.1186/s12879-018-3426-9) contains supplementary material, which is available to authorized users.
Maria Mazzitelli and Carlo Torti contributed equally to this work.
Possible cardiotoxicity of sofosbuvir in humans has not been demonstrated yet. Also, since HCV can exert deleterious effects on hearth function, it is of interest to know whether HCV eradication provides any benefits using global longitudinal strain (GLS), a measure of left ventricular function more reliable than ejection fraction (EF).
Patients eligible for treatment with the combination therapy for HCV were invited to perform a transthoracic cardiac ultrasound at four different time points: before starting treatment, after one month, at the end of treatment and, after six month. Left ventricular function was measured with both EF and GLS.
From March 2015 to December 2016, 82 patients were enrolled. Fifty-six percent patients were males. Mean age was 66.12 (SD: 9.25) years. About 20% patients did not present any cardiovascular risk factors or comorbidities. A worsening trend of GLS was observed. Variations were not found to be statistically significant when EF was studied along the follow-up. However, when GLS was studied, its variations were found to be statistically significant indicating a worsening effect, albeit with different trends in patients who underwent treatment for three months compared to six months. Worsening of GLS was found to be statistically significant even after adjusting for body mass index and liver fibrosis, independently from treatment duration.
Our results showed unexpected worsening of left ventricular function when measured through GLS after HCV treatment response induced by DAAs including sofosbuvir. Although this result is not proven to be clinically significant, the safety profile of sofosbuvir-based regimens needs to be studied further.
Additional file 1: Table S1. AIFA (Italian Regulatory Agency for Drug Administration) criteria for prescription of a DAA treatment. Table S2. Association between global longitudinal strain (dichotomized on median) and demographical and clinical features at baseline. Table S3. Multivariate mixed model, effect of time, BMI, presence of significant liver fibrosis and duration of treatment on global longitudinal strain. (DOCX 24 kb)12879_2018_3426_MOESM1_ESM.docx
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- Evaluation of cardiac function by global longitudinal strain before and after treatment with sofosbuvir-based regimens in HCV infected patients
Greta Luana D’Ascoli
Salvatore De Rosa
Maria Carla Liberto
the CARDIAC study group
- BioMed Central
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