Long-duration HIV infection (≥5 years) was associated with higher extracellular matrix volume index (14.73 vs 10.52 mL/m2) and reduced global radial strain (29.82% vs 36.18%) vs controls.
Cross-Sectional (n=117)
Does HIV infection duration associate with left ventricular concentric remodeling and myocardial fibrosis as assessed by cardiac MRI?
Cardiac MRI reveals that longer duration of HIV infection is associated with progressive left ventricular concentric remodeling and myocardial fibrosis.
Absolute Event Rate: 14.73% vs 10.52%
p-value: p=<0.05
ABSTRACT Background Antiretroviral therapy has transformed HIV into a chronic condition, yet cardiac injury remains a major issue. Purpose To assess the ability of cardiac MR imaging markers to predict cardiac injury and disease progression in HIV‐infected individuals. Study Type Prospective. Subjects Eighty‐three HIV‐infected participants (short‐duration infection < 5 years, n = 43; long‐duration ≥ 5 years, n = 40) and 34 matched HIV‐negative controls. Field Strength/Sequence 1.5 T; SSFP cine and MOLLI sequences. Assessment Left ventricular (LV) end diastolic volume indexed to body surface area (LVEDVi), ejection fraction (LVEF), mass (LVM), myocardial mass‐to‐volume ratio (MVR), and global strains were determined from SSFP cine data. Extracellular volume (ECV) and myocardial extracellular matrix volume index (ECMVi) were determined from pre‐ and post‐contrast myocardial T1 values. Statistical Tests ANOVA, Kruskal–Wallis, post hoc tests, correlation, and multivariable logistic regression; p < 0.05 indicated statistical significance. Results Both the HIV groups showed significantly elevated ECV (short: median 28.02 25.40–31.86%; long: median 28.18 24.40–37.99% vs. 25.07% ± 5.61%) and myocardial native T1 (1863.35 ± 300.29 ms; median 1963.00 1807.00, 2072.25 ms vs. median 1734 1309.75–1981.50 ms) compared to controls. The long‐duration group exhibited significantly higher ECMVi (14.73 ± 4.59 mL/m 2 vs. controls: 10.52 ± 2.82 mL/m 2 and short: 12.32 ± 2.83 mL/m 2 ) and MVR (0.78 ± 0.16 vs. 0.61 ± 0.11 g/mL and median 0.63 0.55–0.69 g/mL), significantly reduced LVEDVi (65.44 ± 13.21 vs. 73.42 ± 10.99 and 72.08 ± 10.62 mL/m 2 ) and significantly diminished global radial strain (29.82% ± 6.28% vs. controls: 36.18% ± 6.39% and short: median 33.16 28.44–37.52%).HIV duration correlated positively with ECMVi and MVR ( r = 0.277 and 0.474, respectively), and significantly negatively correlated with global radial strain ( r = −0.244). Two robust MRI models were validated: ECV/native T1/fasting blood glucose (FBG) for early HIV (AUC = 0.852) and LVEDVi/ECMVi/FBG for duration stratification (AUC = 0.844), with stable performance through bootstrapping and calibration. Conclusion ECV, myocardial native T1, and FBG can predict short‐duration HIV infection, while a multimodal model (LVEDVi, ECMVi, and FBG)stratifies duration. However, prospective validation is necessary. Evidence Level 2. Technical Efficacy Stage 3.
Deng et al. (Thu,) conducted a cross-sectional in HIV infection (n=117). Long-duration HIV infection (≥ 5 years) vs. HIV-negative controls and short-duration HIV infection was evaluated on Myocardial extracellular matrix volume index (ECMVi) (p=<0.05). Long-duration HIV infection (≥5 years) was associated with higher extracellular matrix volume index (14.73 vs 10.52 mL/m2) and reduced global radial strain (29.82% vs 36.18%) vs controls.
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