The effects of HIV on brain metabolites and cognitive function are not well understood. Sixteen HIV+youths (15 vertical, 1 transfusion transmissions) receiving combination antiretroviral therapy and 14 age-matched HIV-youths (13–25 years of age) were evaluated with brain two-dimensional (2D) magnetic resonance spectroscopy (MRS) at 3 Tesla (T) and a neuropsychological battery that assessed three cognitive domains (attention/processing speed, psychomotor ability, and executive function). The relationship between brain metabolite ratios and cognitive performance was explored. Compared to HIV− controls, HIV+subjects had higher sycllo-inositol (Scy)/total creatine (tCr) (+32%, p=0.016) and higher Scy/total choline (tCho) (+31%, p=0.018) on 2D-MRS in the right frontal lobe. HIV+ subjects also had higher glutamate (Glu)/tCr (+13%, p=0.022) and higher Glu/tCho (+15%, p=0.048) than controls. HIV+subjects demonstrated poorer attention/processing speed (p=0.011, d=1.03) but similar psychomotor and executive function compared to HIV− controls. The attention/processing score also correlated negatively with the ratio of N-acetylaspartate (NAA) to tCr on 2D-MRS (r=−0.75, p=0.0019) in the HIV− controls, but not in the HIV+ subjects (Fisher’s r-z transformation, p<0.05). Our results suggest that attention/processing speed is impacted by early HIV infection and is associated with right hemisphere NAA/tCr. Scy and Glu ratios are also potential markers of brain health in chronic, lifelong HIV infection in perinatally infected youths receiving antiretroviral therapy.

In patients suspected of having PVC-CM, IC-AADs effectively suppressed PVCs, leading to LVEF recovery in the majority. No adverse events occurred in this small cohort.

Intra-atrial dyssynchrony during sinus rhythm is an independent predictor of recurrence after the first catheter ablation of paroxysmal or persistent AF. Assessment of intra-atrial dyssynchrony may improve ablation outcomes by refining patient selection.

Important prognostic information regarding AF risk is obtained with follow-up MAC measurement, as the risk for participants with any MAC progression was substantively greater than participants without progression. MAC progression may detect underlying left atrial abnormalities that predispose to AF.