Increased pericardial fat accumulation is associated with increased intramyocardial lipid content and duration of highly active antiretroviral therapy exposure in patients infected with human immunodeficiency virus: a 3T cardiovascular magnetic resonance feasibility study

Journal of Cardiovascular Magnetic Resonance

Research

Debiao Li¹  Zhaoyang Fan¹  Rohan Dharmakumar¹  Daniel Berman¹  Damini Dey¹  Lidia S. Szczepaniak²  W. David Hardy³  Antonio Hernandez Conte⁴  Troy LaBounty⁵  Michael Nelson⁶  Bill Pei-Chin Hsieh⁷  Ronak Rajani⁷  Mariana Diaz-Zamudio⁷ 

[1] Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA;Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA;Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA;David-Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA;Department of Anesthesiology, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Suite 8211, 90048, Los Angeles, CA, USA;Department of Medicine, Cardiovascular Center, University of Michigan, Ann Arbor, MI, USA;Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA;Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA;Division of Nuclear Medicine, Department of Imaging & Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA;

关键词: Human immunodeficiency virus;    HIV;    Cardiovascular magnetic resonance;    Spectroscopy;    Pericardial fat;    Highly active antiretroviral therapy;    HAART;    Intramyocardial lipid content;   

DOI  :  10.1186/s12968-015-0193-2

 received in 2015-07-20, accepted in 2015-10-09,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundThe aim of the current study was to examine whether the use of highly active antiretroviral therapy (HAART) in patients with HIV is associated with changes in pericardial fat and myocardial lipid content measured by cardiovascular magnetic resonance (CMR).MethodsIn this prospective case-control study, we compared 27 HIV seropositive (+) male subjects receiving HAART to 22 control male subjects without HIV matched for age, ethnicity and body mass index. All participants underwent CMR imaging for determination of pericardial fat [as volume at the level of the origin of the left main coronary artery (LM) and at the right ventricular free wall] and magnetic resonance spectroscopy (MRS) for evaluation of intramyocardial lipid content (% of fat to water in a single voxel at the interventricular septum). All measurements were made by two experienced readers blinded to the clinical history of the study participants. Two-sample t-test, Spearman’s correlation coefficient or Pearson’s correlation coefficient and multivariable logistic regression were used for statistical analysis.ResultsPericardial fat volume at the level of LM origin was higher in HIV (+) subjects (33.4 cm3 vs. 27.4 cm3, p = 0.03). On multivariable analysis adjusted for age, Framingham risk score (FRS) and waist/hip ratio, pericardial fat remained significantly associated to HIV-status (OR 1.09, p = 0.047). For both HIV (+) and HIV (-) subjects, pericardial fat volume showed strong correlation with intramyocardial lipid content (r = 0.58, p < 0.0001) and FRS (r = 0.53, p = 0.0002). Among HIV (+) subjects, pericardial fat was significantly higher in patients with lipo-accumulation (37 cm3 vs. 27.1 cm3, p = 0.03) and showed significant correlation with duration of both HIV infection (r = 0.5, p = 0.01) and HAART (r = 0.46, p = 0.02).ConclusionsPericardial fat content is increased in HIV (+) subjects on chronic HAART (>5 years), who demonstrate HAART-related lipo-accumulation and prolonged HIV duration of infection. Further investigation is warranted to determine whether increased pericardial fat is associated with higher cardiovascular risk leading to premature cardiovascular events in this patient population.

【 授权许可】

CC BY   
© Diaz-Zamudio et al. 2015