Key result
ART-naïve HIV infection linked to ~166% higher LVDD prevalence compared to healthy controls.
Why the study?
Cardiovascular disease and left heart dysfunction are major complications in HIV/AIDS, but left cardiac structure, function, and risk factors for diastolic dysfunction required evaluation in ART-naive individuals.
Does HIV infection without antiretroviral therapy affect left cardiac structure and function in adults?
Case-Control (n=195)
No
Does HIV infection without antiretroviral therapy affect left cardiac structure and function in adults?
ART-naïve HIV infection is associated with early left ventricular diastolic dysfunction, which is independently predicted by older age, higher BMI, and lower CD4+ cell counts.
Answers are grounded in this paper and cite their sources.
Associated with higher LVDD in ART-naïve HIV; hypothesis-generating and leaves practice implications open pending prospective data.
Background: Patients with human immunodeficiency virus (HIV) are at a significantly higher risk of cardiovascular disease (CVD) compared to HIV-negative people. CVD has become one of the leading causes of death from non-acquired immune deficiency syndrom (AIDS)-related events in people living with HIV/AIDS (PLWHA). Left heart dysfunction is the most common cardiac complication in PLWHA, and diastolic dysfunction is an important predictor of cardiovascular events. The aims of this study were 1) to detect changes in left cardiac structure and function in antiretroviral therapy (ART)-naive PLWHA using echocardiography; and 2) to investigate the risk factors for the development of left ventricular diastolic dysfunction (LVDD) in ART-naive PLWHA. Methods: We retrospectively included 105 ART-naïve PLWHA and included 90 healthy subjects as controls to compare the differences in left heart structure and function between the two groups. Univariate and multifactorial logistic regression were employed to explore the risk factors of the development of LVDD in ART-naive PLWHA. Results: The left ventricular end-diastolic internal diameter (LVEDD), left ventricular mass index (LVMI), and left atrial volume index (LAVI) were significantly greater in PLWHA than in controls ( p ＜0.05). The E/A ratio, lateral e' velocity, and mitral deceleration time (DT) were significantly lower in PLWHA than in controls ( p < 0.05). Average E/e' ratio was significantly higher in PLWHA than in controls ( p < 0.05). Left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were not significantly different between PLWHA and controls ( p ＞0.05). Multifactorial logistic regression analysis showed that age, body mass index (BMI), and CD4+ count < 200 cells/μL were independent influencing factors for LVDD in ART-naive PLWHA (OR=1.781, 1.228, 3.683, p ＜0.05). Conclusions: Left ventricular systolic function did not differ between PLWHA and controls, and left ventricular diastolic function was lower in PLWHA than in controls. Age, BMI, and CD4+ count were independent factors affecting LVDD in ART-naive PLWHA. Trial registration: ChiCTR1900021008，2019/01/24
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Hu et al. (2022) conducted a case-control in HIV/AIDS (n=195). HIV infection (ART-naïve) vs. Healthy controls was evaluated on Prevalence of left ventricular diastolic dysfunction (LVDD) (p=<0.05). ART-naïve people living with HIV/AIDS had a higher prevalence of left ventricular diastolic dysfunction compared to healthy controls.
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