Key result
ART-naive HIV infection linked to a ~162% higher prevalence of LVDD versus healthy controls.
Why the study?
Patients with HIV have a significantly higher risk of cardiovascular disease, and accurate assessment of cardiac function in ART-naive HIV-infected patients is important to guide treatment and prognosis.
Are there structural and functional alterations in the left heart in ART-naive HIV-infected patients compared to healthy subjects?
Case-Control (n=145)
No
Are there structural and functional alterations in the left heart in ART-naive HIV-infected patients compared to healthy subjects?
Absolute Event Rate: 59% vs 22.5%
p-value: p=<0.05
ART-naive HIV-infected patients exhibit subclinical left ventricular diastolic dysfunction and structural changes compared to healthy controls, driven by age, BMI, and lower CD4+ counts.
Suggests cardiac screening in ART-naive HIV; leaves open whether early ART prevents progression.
Background: Patients with human immunodeficiency virus (HIV) are at a significantly higher risk of cardiovascular disease compared to the general population, and cardiovascular disease (CVD) is a significant cause of death in patients with acquired immune deficiency syndrome (AIDS). Accurate assessment of the cardiac function status of HIV-infected patients is important to guide clinical treatment and improve the prognosis. The aim of this study was to investigate structural and functional alterations in the left heart in antiretroviral therapy (ART)-naive HIV infected patients and their associated risk factors for the development of left ventricular diastolic dysfunction (LVDD).Methods: We retrospectively included 105 ART-naive HIV-infected patients and 40 healthy subjects who underwent physical examination during the same period and performed echocardiography to compare the differences in the left heart structure and function between HIV-infected patients and healthy subjects. Univariate and multifactorial logistic regression were employed to explore the risk factors of the development of LVDD in ART-naive HIV-infected patients. Results: The left ventricular end-diastolic internal diameter (LVEDD), left ventricular mass index (LVMI), and left atrial volume index (LAVI) were significantly greater in HIV-infected patients than in controls (p＜0.05). Left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were not significantly different between HIV-infected patients and controls (p＞0.05). The ratio of peak early-diastolic flow velocity to peak end-diastolic flow velocity (E/A), early diastolic mitral annular velocity (e'), and deceleration time (DT) of early left ventricular filling were significantly lower in HIV-infected patients than in controls (p＜0.05). Multifactorial logistic regression analysis showed that age, body mass index (BMI), and CD4+ count were independent influencing factors for LVDD in ART-naive HIV-infected patients (OR=2.094, 1.229, 0.642, p＜0.05).Conclusions: Left ventricular systolic function did not differ between HIV-infected patients and controls, and left ventricular diastolic function was lower in HIV-infected patients than in controls. Age, BMI, and CD4+ count were independent factors affecting LVDD in ART-naive HIV-infected patients.Trial registration: ChiCTR1900021008，2019/01/24
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Hu et al. (2022) conducted a case-control in ART-naive HIV infection (n=145). ART-naive HIV infection vs. HIV-negative healthy subjects was evaluated on Left ventricular diastolic dysfunction (LVDD) (p=<0.05). ART-naive HIV infection was associated with a significantly higher prevalence of left ventricular diastolic dysfunction compared to healthy controls (59.0% vs 22.5%).
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