James D Wilkinson1,2, Paige L Williams3, Wendy Yu3, Steven D Colan4, Armando Mendez5, Justin P V Zachariah6, Russell B Van Dyke7, William T Shearer8, Renee E Margossian4, Steven E Lipshultz1. 1. Department of Pediatrics, School of Medicine, Wayne State University, Detroit, Michigan. 2. Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee. 3. Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston. 4. Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts. 5. Diabetes Research Institute Foundation, Miller School of Medicine, University of Miami, Miami, Florida. 6. Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas. 7. Department of Pediatrics, Tulane University, New Orleans, Los Angeles. 8. Department of Pediatrics and Pathology & Immunology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.
Abstract
OBJECTIVES: To compare distributions of serum cardiac and inflammatory biomarkers between perinatally HIV-infected (PHIV) and perinatally HIV-exposed uninfected (PHEU) children, to evaluate their associations with echocardiographic measures, and among PHIV youth, with antiretroviral therapy (ART) and HIV disease severity measures. DESIGN: Cross-sectional analysis of temporally paired serum samples for biomarkers and echocardiograms in a prospective multicenter cohort study of PHIV and PHEU youth. METHODS: Serum samples were analyzed among 402 youth in the PHACS Adolescent Master Protocol (AMP) for high-sensitivity cardiac troponin-T (hs-cTnT, a cardiomyocyte injury marker), N-terminal-pro-brain natriuretic peptide (NT-proBNP, a myocardial stress marker), and inflammatory markers [high-sensitivity C-reactive protein, interleukin (IL)-1, IL-6, IL-8, IL-10, IL-18, tumor necrosis factor-α (TNF-α), and soluble TNF receptor II (sTNF-RII)]. Echocardiograms were centrally measured and parameters converted to z cores to account for differences in age and body size. RESULTS: Compared with PHEU (N = 156), PHIV youth (N = 246) more often had detectable hs-cTnT and higher levels of sTNF-RII and IL-18. Higher inflammatory biomarkers were generally associated with higher left ventricular (LV) wall stress and lower LV function and LV mass in the two groups. Among PHIV youth, the biomarkers were more strongly associated with current rather than historical immunologic and virologic status. CONCLUSION: PHEU and PHIV have modest, significant differences in serum levels of specific inflammatory and active myocardial injury biomarkers. Higher biomarker levels were associated with lower LV mass and shifts in LV structure. Further study is warranted on the longitudinal role of cardiac and inflammatory biomarkers for targeting interventions among PHIV and PHEU youth.
OBJECTIVES: To compare distributions of serum cardiac and inflammatory biomarkers between perinatally HIV-infected (PHIV) and perinatally HIV-exposed uninfected (PHEU) children, to evaluate their associations with echocardiographic measures, and among PHIV youth, with antiretroviral therapy (ART) and HIV disease severity measures. DESIGN: Cross-sectional analysis of temporally paired serum samples for biomarkers and echocardiograms in a prospective multicenter cohort study of PHIV and PHEU youth. METHODS: Serum samples were analyzed among 402 youth in the PHACS Adolescent Master Protocol (AMP) for high-sensitivity cardiac troponin-T (hs-cTnT, a cardiomyocyte injury marker), N-terminal-pro-brain natriuretic peptide (NT-proBNP, a myocardial stress marker), and inflammatory markers [high-sensitivity C-reactive protein, interleukin (IL)-1, IL-6, IL-8, IL-10, IL-18, tumornecrosis factor-α (TNF-α), and soluble TNF receptor II (sTNF-RII)]. Echocardiograms were centrally measured and parameters converted to z cores to account for differences in age and body size. RESULTS: Compared with PHEU (N = 156), PHIV youth (N = 246) more often had detectable hs-cTnT and higher levels of sTNF-RII and IL-18. Higher inflammatory biomarkers were generally associated with higher left ventricular (LV) wall stress and lower LV function and LV mass in the two groups. Among PHIV youth, the biomarkers were more strongly associated with current rather than historical immunologic and virologic status. CONCLUSION: PHEU and PHIV have modest, significant differences in serum levels of specific inflammatory and active myocardial injury biomarkers. Higher biomarker levels were associated with lower LV mass and shifts in LV structure. Further study is warranted on the longitudinal role of cardiac and inflammatory biomarkers for targeting interventions among PHIV and PHEU youth.
Authors: Steven E Lipshultz; William T Shearer; Bruce Thompson; Kenneth C Rich; Irene Cheng; E John Orav; Sulekha Kumar; Ricardo H Pignatelli; Louis I Bezold; Philip LaRussa; Thomas J Starc; Julie S Glickstein; Sharon O'Brien; Ellen R Cooper; James D Wilkinson; Tracie L Miller; Steven D Colan Journal: J Am Coll Cardiol Date: 2011-01-04 Impact factor: 24.094
Authors: Kunjal Patel; Russell B Van Dyke; Murray A Mittleman; Steven D Colan; James M Oleske; George R Seage Journal: AIDS Date: 2012-10-23 Impact factor: 4.177
Authors: Eric A Secemsky; Rebecca Scherzer; Elaine Nitta; Alan H B Wu; David C Lange; Steven G Deeks; Jeffrey N Martin; James Snider; Peter Ganz; Priscilla Y Hsue Journal: JACC Heart Fail Date: 2015-07-08 Impact factor: 12.035
Authors: Stefan Blankenberg; Laurence Tiret; Christoph Bickel; Dirk Peetz; François Cambien; Jürgen Meyer; Hans J Rupprecht Journal: Circulation Date: 2002-07-02 Impact factor: 29.690
Authors: Ramachandran S Vasan; Lisa M Sullivan; Ronenn Roubenoff; Charles A Dinarello; Tamara Harris; Emelia J Benjamin; Douglas B Sawyer; Daniel Levy; Peter W F Wilson; Ralph B D'Agostino Journal: Circulation Date: 2003-03-25 Impact factor: 29.690