BACKGROUND: Patients with HIV have increased risk for cardiovascular disease, but the underlying mechanisms remain unknown. The purpose of this study was to determine the prevalence of echocardiographic abnormalities among asymptomatic HIV-infected individuals compared with HIV-uninfected individuals. Methods/Results- We performed echocardiography in 196 HIV-infected adults and 52 controls. Left ventricular ejection fraction, left ventricular mass indexed to the body surface area, and diastolic function were assessed according to American Society of Echocardiography standards. Left ventricular mass index was higher in HIV-infected patients (77.2 g/m(2) in patients with HIV versus 66.5 g/m(2) in controls, P<0.0001). Left ventricular ejection fraction was similar in both groups. Eight (4%) of the patients with HIV had evidence of left ventricular systolic dysfunction (defined as an EF <50%) versus none of the controls; 97 (50%) had mild diastolic dysfunction compared with 29% of the HIV-uninfected subjects (P=0.008). After adjustment for hypertension and race, HIV-infected participants had a mean 8 g/m(2) larger left ventricular mass index compared with controls (P=0.001). Higher left ventricular mass index was independently associated with lower nadir CD4 T-cell count, suggesting that immunodeficiency may play a role in this process. After adjustment for age and traditional risk factors, patients with HIV had a 2.4 greater odds of having diastolic dysfunction as compared with controls (P=0.019). CONCLUSIONS: HIV-infected patients had a higher prevalence of diastolic dysfunction and higher left ventricular mass index compared with controls. These differences were not readily explained by differences in traditional risk factors and were independently associated with HIV infection. These results suggest that contemporary asymptomatic patients with HIV manifest mild functional and morphological cardiac abnormalities, which are independently associated with HIV infection.
BACKGROUND:Patients with HIV have increased risk for cardiovascular disease, but the underlying mechanisms remain unknown. The purpose of this study was to determine the prevalence of echocardiographic abnormalities among asymptomatic HIV-infected individuals compared with HIV-uninfected individuals. Methods/Results- We performed echocardiography in 196 HIV-infected adults and 52 controls. Left ventricular ejection fraction, left ventricular mass indexed to the body surface area, and diastolic function were assessed according to American Society of Echocardiography standards. Left ventricular mass index was higher in HIV-infectedpatients (77.2 g/m(2) in patients with HIV versus 66.5 g/m(2) in controls, P<0.0001). Left ventricular ejection fraction was similar in both groups. Eight (4%) of the patients with HIV had evidence of left ventricular systolic dysfunction (defined as an EF <50%) versus none of the controls; 97 (50%) had mild diastolic dysfunction compared with 29% of the HIV-uninfected subjects (P=0.008). After adjustment for hypertension and race, HIV-infectedparticipants had a mean 8 g/m(2) larger left ventricular mass index compared with controls (P=0.001). Higher left ventricular mass index was independently associated with lower nadir CD4 T-cell count, suggesting that immunodeficiency may play a role in this process. After adjustment for age and traditional risk factors, patients with HIV had a 2.4 greater odds of having diastolic dysfunction as compared with controls (P=0.019). CONCLUSIONS:HIV-infectedpatients had a higher prevalence of diastolic dysfunction and higher left ventricular mass index compared with controls. These differences were not readily explained by differences in traditional risk factors and were independently associated with HIV infection. These results suggest that contemporary asymptomatic patients with HIV manifest mild functional and morphological cardiac abnormalities, which are independently associated with HIV infection.
Authors: H Rakowski; C Appleton; K L Chan; J G Dumesnil; G Honos; J Jue; C Koilpillai; S Lepage; R P Martin; L A Mercier; B O'Kelly; T Prieur; A Sanfilippo; Z Sasson; N Alvarez; R Pruitt; C Thompson; C Tomlinson Journal: J Am Soc Echocardiogr Date: 1996 Sep-Oct Impact factor: 5.251
Authors: A Herskowitz; T C Wu; S B Willoughby; D Vlahov; A A Ansari; W E Beschorner; K L Baughman Journal: J Am Coll Cardiol Date: 1994-10 Impact factor: 24.094
Authors: P A Heidenreich; M J Eisenberg; L L Kee; C A Somelofski; H Hollander; N B Schiller; M D Cheitlin Journal: Circulation Date: 1995-12-01 Impact factor: 29.690
Authors: Priscilla Y Hsue; Joan C Lo; Arlana Franklin; Ann F Bolger; Jeffrey N Martin; Steven G Deeks; David D Waters Journal: Circulation Date: 2004-03-15 Impact factor: 29.690
Authors: Adeel A Butt; Chung-Chou Chang; Lewis Kuller; Matthew Bidwell Goetz; David Leaf; David Rimland; Cynthia L Gibert; Krisann K Oursler; Maria C Rodriguez-Barradas; Joseph Lim; Lewis E Kazis; Stephen Gottlieb; Amy C Justice; Matthew S Freiberg Journal: Arch Intern Med Date: 2011-04-25
Authors: Matthew J Feinstein; Milana Bogorodskaya; Gerald S Bloomfield; Rajesh Vedanthan; Mark J Siedner; Gene F Kwan; Christopher T Longenecker Journal: Curr Cardiol Rep Date: 2016-11 Impact factor: 2.931
Authors: Amy E Sims Sanyahumbi; Mina C Hosseinipour; Danielle Guffey; Irving Hoffman; Peter N Kazembe; Madeline McCrary; Charles G Minard; Charles van der Horst; Craig A Sable Journal: Pediatr Infect Dis J Date: 2017-07 Impact factor: 2.129
Authors: Brian S Moyers; Eric A Secemsky; Eric Vittinghoff; Joseph K Wong; Diane V Havlir; Priscilla Y Hsue; Zian H Tseng Journal: Am J Cardiol Date: 2014-01-16 Impact factor: 2.778
Authors: David B Hanna; Chitra Ramaswamy; Robert C Kaplan; Jorge R Kizer; Kathryn Anastos; Demetre Daskalakis; Regina Zimmerman; Sarah L Braunstein Journal: Clin Infect Dis Date: 2016-07-20 Impact factor: 9.079