Background: Infection with Hepatitis C virus (HCV) is of significant public-health encumbrance in Egyptian population that afford the considerable predominance rate worldwide. This study was aimed to evaluate the correlation between the different treatment regimens on cardiac cardiovascular complication. Methods and Results: In this study, 390 patients diagnosed as HCV infection in Mansoura, Egypt were sectioned into four groups. Group A treated with ledipasvir and sofosbuvir (LED +SOF), group B received simepriver and sofosbuvir (SIM+SOF), group C treated sofosbuvir and daclatasvir (Sof+DCV) and group D received with triple combination therapy of sofosbuvir, daclatasvir and ribavirin (SOF+DCV+ RBV). The full hepatological assessment, blood analysis and clinical investigation were performed. All participants went through a cardiac assessment for detection of development of cardiovascular changes. There was significant elevation in levels of AST, ALT, serum albumin, platelet count, heamoglobin concentration and the Child classification between the studied groups. There was significant difference in the CMR results during the study especially in fourth group (SOF+DCV+RBV) group. No statistical difference regarding pericardial effusion. There was significant elevation of cardiac enzymes (Troponin, CK MB, BNP ) mostly in all groups especially in the fourth group (SOF+DCV+ RBV) with one outlier in SOF+DCV group and 3 outliers presented mainly with BNP (P value <0.001). Conclusions: DAAs are proved its efficacy in management of chronic HCV in Egyptian patients as standard of care for hepatitis C treatment. Also tested its safety on the heart with most of its applied regimens.

Background: Right Ventricular (RV) dysfunction considered as a predictor of mortality in patients with ischemic heart disease (IHD). Aim: This study was aimed to evaluate the impact of elective coronary artery revascularization on RV myocardial function in Egyptian patients with IHD using Colour Tissue Doppler Imaging (CTDI). Methods: The present study is prospective observational self-control study. Fifty consecutive patients with IHD were included in this study. All participants were subjected to physical examination, Electrocardiograph (ECG), Laboratory test, Transthoracic Echocardiography and color tissue Doppler Imaging. The RV myocardial performance index (MPI) and S'/RMPI index were calculated in TDI modalities parameters. Results: No significant differences were detected between the demographic characteristics of the investigated patients. Tricuspid annular plane systolic excursion (TAPSE) by echocardiographic RV function parameters was improved significantly after PCI (P=0.001). Most of RV myocardial function showed significant improvement after PCI by using PW-DTI: Early and late diastolic function: The E` and A` diastolic wave velocities were improved significantly after PCI (P= 0.003, P= 0.008 respectively), RMPI (P= 0.008) Sˋ/RIMP ratio (P=0.04). The myocardial functions showed significant improvement after PCI by using color-coded tissue Doppler; E` wave (P= 0.02), RMPI was improved significantly after PCI (P= 0.01). Conclusion: The TAPSE and Doppler tissue indices added important information to the RV functions after successful percutaneous revisualization of coronary arteries. The measurements performed by color-coded TDI derived myocardial velocities at basal, mid and apical might have added additional data describing RV function and its recovery after RV ischemia.

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Cardiovascular problems are still the leading cause of deaths globally. Socioeconomic inequality continues to pose a challenge to health care suppliers and can greatly affect the clinical outcome of medical problems, especially in the cardiovascular field. This study aimed to assess the in-hospital outcome of patients with acute coronary syndrome admitted in the coronary care unit and to determine the relation between socioeconomic status (SES) and in-hospital outcome of acute coronary syndrome. A prospective observational study was conducted on 301 patients presented with acute coronary syndrome during the period from August 2015 to May 2016. A questionnaire was used to assess their socioeconomic status. Admitted patients with acute coronary syndrome (ACS) were classified into 31 (10.3%) patients with non-ST segment elevation myocardial infarction (NSTEMI), 162 (53.8%) with ST segment elevation myocardial infarction STEMI and 108 (35.9%) with unstable angina (UA). According to patients SES, they were classified as 77 with high SES, 74 with middle SES, 84 with low SES, and 66 with very low SES. The study revealed that the lower socioeconomic status was statistically significant associated with increase of acute coronary syndrome mortality (P <0.001), the incidence of impaired left ventricular function, heart failure and stroke was associated. While, lower socioeconomic status was significantly associated decrease in the incidence of coronary angiography and percutaneous intervention. No significant change in the incidence of arrhythmia and major bleeding between socioeconomic status classes. Lower socioeconomic status in patients with acute coronary syndrome was considered as a risk factor for increased in-hospital mortality, stroke, impaired left ventricular function, and heart failure. To the best of author's knowledge, this study considered first report in Egypt discussing the in-hospital outcome of patients with ACS and to determine the relation between SES and in-hospital outcome of ACS patients.

Background: Acute coronary syndrome (ACS) is accounting for any condition causing sudden reduced blood flow to the heart. Some trace elements play role in the development of ACS. Aim: This study aimed to evaluate the linkage between serum zinc, copper, iron level and cardiac markers in acute coronary syndromes. Methods: Eighty patients were divided into four groups. Group I (patients with unstable angina), Group II (acute myocardial infarction early 6 h), group III (acute myocardial infarction late 6 h) and group IV (patients with reperfusion therapy). Fifteen apparently healthy individuals served as a control group. Different risk factors as age, sex, diabetes and dyslipideamia were addressed in different groups. The correlation between Fe, Zn and Cu versus cardiac enzymes were demonstrated. The receiver operating characteristic (ROC) analysis was conducted. Results: Male and diabetic patients were significantly higher. The CK and Tn were significantly increased in groups I, II and III. The CK-MB levels were significantly increased in group II and group III. The AST levels were significantly increased in group III. The serum iron level was significantly lower in group I, II and III. Serum zinc show slight decrease in groups II and III. No significant correlation was obtained concerning serum Cu. In group II, there were significant positive correlation between Fe versus Tn, CK-MB and CK. The (ROC) analysis was identified the optimal Fe, Zn and Cu plasma level for potential prediction of development of ACS. Conclusion: Fe and Zn values were lower in ACS patients. Cu values did not show difference.