Associations Between HIV Serostatus and Cardiac Structure and Function Evaluated by 2‐Dimensional Echocardiography in the Multicenter AIDS Cohort Study

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

Matthew J. Feinstein¹  Carlos Malvestutto²  Jared W. Magnani³  Ann‐Margret Ervin⁴  Sabina Annette Haberlen⁴  Henrique Doria de Vasconcellos⁵  Wendy S. Post⁵  Joao A. C. Lima⁵  Todd T. Brown⁵  Katherine C. Wu⁵  Matthew Budoff⁶ 

[1] Department of Medicine Northwestern University Feinberg School of Medicine Chicago IL;Department of Medicine Ohio State University OH;Department of Medicine University of Pittsburgh PA;Johns Hopkins Bloomberg School of Public Health Baltimore MD;Johns Hopkins University School of Medicine Baltimore MD;Lundquist Institute at Harbor‐UCLA Medical Center Los Angeles CA;

关键词: antiretroviral therapy;    atria;    cardiac remodeling;    diastolic dysfunction;    echocardiography;    HIV/AIDS;   

DOI  :  10.1161/JAHA.120.019709

来源: DOAJ

【 摘 要 】

Background We aimed to investigate whether there are differences in cardiac structure and systolic and diastolic function evaluated by 2‐dimensional echocardiography among men living with versus without HIV in the era of combination antiretroviral therapy. Methods and Results We performed a cross‐sectional analysis of 1195 men from MACS (Multicenter AIDS Cohort Study) who completed a transthoracic echocardiogram examination between 2017 and 2019. Associations between HIV serostatus and echocardiographic indices were assessed by multivariable regression analyses, adjusting for demographics and cardiovascular risk factors. Among men who are HIV+, associations between HIV disease severity markers and echocardiographic parameters were also investigated. Average age was 57.1±11.9 years; 29% of the participants were Black, and 55% were HIV+. Most men who were HIV+ (77%) were virally suppressed; 92% received combination antiretroviral therapy. Prevalent left ventricular (LV) systolic dysfunction (ejection fraction <50%) was low and HIV serostatus was not associated with left ventricular ejection fraction. Multivariable adjustment models showed that men who were HIV+ versus those who were HIV− had greater LV mass index and larger left atrial diameter and right ventricular (RV) end‐diastolic area; lower RV function; and higher prevalence of diastolic dysfunction. Higher current CD4+ T cell count ≥400 cell/mm3 versus <400 was associated with smaller LV diastolic volume and RV area. Virally suppressed men who were HIV+ versus those who were HIV− had higher indexed LV mass and left atrial areas and greater diastolic dysfunction. Conclusions HIV seropositivity was independently associated with greater LV mass index, left atrial and RV sizes, lower RV function and diastolic abnormalities, but not left ventricular ejection fraction, which may herald a future predisposition to heart failure with preserved ejection fraction among men living with HIV.

【 授权许可】

Unknown