Assessment of subclinical cardiac dysfunction by speckle-tracking echocardiography among people living with human immunodeficiency virus

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Han Siong Toh¹  Hung-Jen Tang²  Carol Strong³  Chia-Te Liao⁴  Zhih-Cherng Chen⁵  Wei-Ting Chang⁶  Chun-Ting Yang⁷ 

[1] Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan;Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan;Department of Health and Nutrition, Chia Nan University of Pharmacy & Science, Tainan, Taiwan;Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan;Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan;Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan;Division of Cardiology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan;Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium;Division of Cardiology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan;Division of Cardiology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan;Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan;Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan;

关键词: HIV/AIDS;    cardiovascular disease;    speckle-tracking echocardiogram;    myocardial strain;    subclinical myocardial dysfunction;   

DOI  :  10.3389/fcvm.2023.1200418

 received in 2023-04-04, accepted in 2023-05-09,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundPeople living with HIV (PLWH) have an increased risk of developing cardiovascular diseases (CVD). As speckle-tracking echocardiography (STE) has been used to detect subclinical myocardial abnormalities, this study aims to detect early cardiac impairment among Asian PLWH using STE and to investigate the associated risk factors.MethodsWe consecutively recruited asymptomatic PLWH without previous CVD from a medical center of Taiwan, and their cardiac function was evaluated by conventional echocardiogram and STE. Enrolled PLWH were classified as antiretroviral therapy (ART)-experienced and ART-naive, and multivariable regressions were used to assess the association between myocardial strain and risk factors including traditional CVD and HIV-associated factors.ResultsA total of 181 PLWH (mean age: 36.4 ± 11.4 years, 173 males) were recruited and conventional echocardiogram parameters were within normal ranges. Decreased myocardial strain across the myocardium was found, with a mean left ventricular (LV) global longitudinal strain of −18.7 ± 2.9%. The LV strain in the ART-experienced group (−19.0 ± 2.9%) was significantly better than the ART-naive group (−17.9 ± 2.8%), despite a younger age and lesser CVD risk factors in the ART-naive group. Hypertension [B = 1.92, 95% confidence interval (95% CI) 0.19–3.62, p = 0.029] and ART-naive with both low and high viral loads (VL) (B = 1.09, 95% CI 0.03–2.16, p = 0.047; and B = 2.00, 95% CI, 0.22–3.79, p = 0.029) were significantly associated with reduced myocardial strain.ConclusionThis is the first and largest cohort using STE to investigate myocardial strain in Asian PLWH. Our results suggest that hypertension and detectable VL are associated with impaired myocardial strain. Thus, timely ART administration with VL suppression and hypertension control are crucial in preventing CVD when making the management parallel with the improved life expectancy of PLWH on ART.

【 授权许可】

Unknown   
© 2023 Liao, Toh, Chang, Yang, Chen, Tang and Strong.