الفهرس 
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Abstract
Background : Egypt has the highest prevalence of HCV worldwide, In addition to liver involvement, extrahepatic manifestations (EHMs) of HCV infection were reported ; multiple organ systems of the body including the heart can be affected with significant morbidity and mortality. Aim : To study different cardiac disorders associated with chronic HCV infection and to study the correlation between the severity of cardiac disorders with the severity of liver fibrosis. Setting : Medical specialized hospital, Mansoura University. Results : This study included 200 patients with chronic HCV infection referred from hepatitis virology clinic to cardiology clinic for any cardiac complaint. patients were divided into 3 groups According to results of Fibroscan ; Group 1 ; Patients with absent or minimal liver fibrosis (F 0 and F1), Group 2 ; Patients with Moderate to severe liver fibrosis (F 2 and F 3) and Group 3 ; Patients with liver cirrhosis (F 4). All patients included in this study underwent detailed clinical evaluation, laboratory investigations, resting 12 lead ECG, Echocardiography and Transient Elastography (Fibroscan). Coronary angiography was done for indicated patients only.In patients with chronic HCV increasing severity of liver fibrosis is associated with left (LV) and right (RV) ventricular systolic and diastolic dysfunction (indicated by significant increase LV and RV myocardial performance index (MPI), significant decrease in LV ejection fraction (EF), mitral valve E/A ratio. Tricuspid Annular plain Systolic Excursion (TAPSE)). Also it is associated with increasing LV mass index (LVMI), pulmonary artery systolic pressure (PASP) and more prolongation of QTc interval. In those with coronary artery disease (CAD), the severity of atherosclerosis increases with increasing severity of liver fibrosis (indicated by increased Gensini and SYNTAX scores, more vessel affection and more complex lesions). Conclusion : HCV is associated with multiple cardiac disorders which increase with increasing the severity of liver fibrosis.