Key result
HIV infection in women is linked to ~3-fold higher intramyocardial triglycerides and reduced diastolic function.
Why the study?
Women with HIV on ART are living longer but face heightened vulnerability to heart failure, prompting investigation into metabolic, hormonal, and immune parameters relating to diastolic dysfunction.
Does HIV infection increase intramyocardial triglyceride content and impair diastolic function in women without known cardiovascular disease?
Cross-Sectional (n=30)
Does HIV infection increase intramyocardial triglyceride content and impair diastolic function in women without known cardiovascular disease?
Absolute Event Rate: 1.2% vs 0.4%
p-value: p=0.01
In asymptomatic women with HIV, increased intramyocardial triglyceride content is associated with diastolic dysfunction and correlates with reproductive aging.
May link HIV to subclinical diastolic changes in women; leaves open causal mechanisms and need for longitudinal confirmation.
CONTEXT: Women with HIV (WHIV) on anti-retroviral therapy (ART) are living longer but facing heightened vulnerability to heart failure. OBJECTIVE: We investigated metabolic/hormonal/immune parameters relating to diastolic dysfunction-a precursor to heart failure-among WHIV without known cardiovascular disease (CVD). DESIGN AND OUTCOME MEASURES: Nineteen ART-treated WHIV and 11 non-HIV-infected women without known CVD enrolled and successfully completed relevant study procedures [cardiac magnetic resonance spectroscopy (MRS) and cardiac MRI]. Groups were matched on age and body mass index. Primary outcome measures included intramyocardial triglyceride content (cardiac MRS) and diastolic function (cardiac MRI). Relationships between intramyocardial triglyceride content and clinical parameters were also assessed. RESULTS: Among WHIV (vs non-HIV-infected women), intramyocardial triglyceride content was threefold higher [1.2 (0.4, 3.1) vs 0.4 (0.1, 0.5)%, P = 0.01], and diastolic function was reduced (left atrial passive ejection fraction: 27.2 ± 9.6 vs 35.9 ± 6.4%, P = 0.007). There was a strong inverse relationship between intramyocardial triglyceride content and diastolic function (ρ = -0.62, P = 0.004). Among the whole group, intramyocardial triglyceride content did not relate to chronologic age but did increase across the reproductive aging spectrum (P = 0.02). HIV status and reproductive aging status remained independent predictors of intramyocardial triglyceride content after adjusting for relevant cardiometabolic parameters (overall model R2 = 0.56, P = 0.003; HIV status P = 0.01, reproductive aging status P = 0.02). CONCLUSIONS: For asymptomatic WHIV, increased intramyocardial triglyceride content is associated with diastolic dysfunction. Moreover, relationships between intramyocardial triglyceride accumulation and women's reproductive aging are noted.
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Toribio et al. (2019) conducted a cross-sectional in HIV without known cardiovascular disease (n=30). HIV infection vs. Non-HIV-infected women was evaluated on Intramyocardial triglyceride content (p=0.01). Among women without known cardiovascular disease, HIV infection was associated with higher intramyocardial triglyceride content (1.2% vs 0.4%, P=0.01) and reduced diastolic function.
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