Key result
Premenopausal women with HIV exhibited significantly reduced microvascular acetylcholine-induced endothelium-dependent relaxation (-51% vs -78%) and enhanced contractility compared to healthy controls.
Why the study?
Does HIV infection impair microvascular endothelial function and enhance contractility in premenopausal women?
Case-Control (n=20)
No
Does HIV infection impair microvascular endothelial function and enhance contractility in premenopausal women?
Absolute Event Rate: -51% vs -78%
p-value: p=<0.05
Premenopausal HIV-positive women on HAART exhibit severe microvascular oxidative stress and endothelial dysfunction, which may herald later cardiovascular disease.
May signal early vascular risk in premenopausal women with HIV; leaves open whether dysfunction predicts clinical events.
11 BACKGROUND: The prevalence of cardiovascular disease is increased with human immunodeficiency virus (HIV) infection, but the mechanism is unclear. We hypothesized that HIV increases microvascular reactive oxygen species, thereby impairing endothelial function and enhancing contractility. 12 METHOD: Subcutaneous microarterioles were isolated from gluteal skin biopsies in premenopausal, African American, HIV positive women receiving effective anti-retroviral therapy, but without cardiovascular risk factors except for increased body mass index (n=10) and healthy matched controls (n=10). The arterioles were mounted on myographs, preconstricted and relaxed with acetylcholine for: endothelium-dependent relaxation, endothelium-dependent relaxation factor (nitric oxide synthase-dependent relaxation), endothelium-dependent hyperpolarizing factor (potassium-channel dependent relaxation) and endothelium-independent relaxation (nitroprusside). Contractions were tested to endothelium-dependent contracting factor (acetylcholine contraction with blocked relaxation); phenylephrine, U-46,619 and endothelin-1. Plasma L-arginine and asymmetric dimethylarginine were measured by high performance capillary electrophoresis. 13 RESULTS: , P<0.05). 14 CONCLUSION: Premenopausal HIV positive womenhad microvascular oxidative stress with severe endothelial dysfunction and reduced nitric oxide and arginine: assymetric dimethylarginine ratio but enhanced endothelial, thromboxane and endothelin contractions. These microvascular changes may herald later cardiovascular disease.
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Dan Wang (2013) conducted a case-control in HIV (n=20). HIV infection vs. Healthy matched controls was evaluated on Acetylcholine-induced endothelium-dependent relaxation (% change in tension) (p=<0.05). Premenopausal women with HIV exhibited significantly reduced microvascular acetylcholine-induced endothelium-dependent relaxation (-51% vs -78%) and enhanced contractility compared to healthy controls.
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