IDIOPATHIC DILATED CARDIOMYOPATHY - LACK OF ASSOCIATION WITH HEPATITIS-C VIRUS-INFECTION

Objective-To determine whether there is an association between hepatit is C virus (HCV) infection and dilated cardiomyopathy in a well define d area of north western Greece; such an association has been reported elsewhere. Design-Evaluation of consecutive patients with chronic HCV infection for the presence of clinical or subclinical manifestations o f dilated cardiomyopathy by history, physical examination, and non-inv asive laboratory procedures (ECG, chest x ray, and echocardiography) b efore the initiation of interferon a treatment; investigation for HCV infection markers in patients with dilated cardiomyopathy by enzyme an d immunoblot assays (antibodies to HCV) and the reverse transcriptase polymerase chain reaction (HCV RNA). Setting-A tertiary referral centr e for patients with chronic hepatitis and dilated cardiomyopathy. Pati ents-102 patients with well defined chronic HCV infection and 55 patie nts with well established dilated cardiomyopathy were evaluated. Main outcome measures-The need for HCV testing in patients with dilated car diomyopathy, or follow up for heart disease in patients with chronic H CV infection. Results-None of the patients with chronic HCV infection had clinical or subclinical evidence of dilated cardiomyopathy from hi story and laboratory findings. None of the patients with dilated cardi omyopathy was positive for antibodies to HCV or viraemic on HCV RNA te sting. Conclusions-The study neither confirms the findings of other in vestigators, nor indicates a pathogenic link between HCV and dilated c ardiomyopathy. For this reason, at least in Greece, testing for HCV in patients with dilated cardiomyopathy or follow up for heart disease i n HCV patients appears unnecessary. Genetic or other factors could be the reason for this discrepancy if previously reported associations be tween HCV and dilated cardiomyopathy or hypertrophic cardiomyopathy we re not coincidental.