Airflow limitation in people living with HIV and matched uninfected controls

Ronit, Andreas; Lundgren, Jens D; Afzal, Shoaib; Benfield, Thomas; Roen, Ashley; Mocroft, Amanda; Gerstoft, Jan; Nordestgaard, Børge G.; Vestbo, Jørgen; Nielsen, Susanne Dam

doi:10.1136/thoraxjnl-2017-211079

Cited by 60 publications

(63 citation statements)

References 41 publications

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“…Using MDCT, we found no difference in LVMi between PLWH and uninfected controls in the unadjusted analysis, but we found HIV was independently associated with larger LVM after adjusting for confounders. This underscores the importance of having well-characterized populations when comparing chamber indices in PLWH and uninfected controls, as confounding risk factors may be unevenly distributed in the two populations [7,26,34,39]. The finding that HIV was associated with larger LVM after adjustment is in line with previous findings and compatible with diastolic dysfunction and a concentric pattern of cardiac remodeling [7,40].…”

Section: Discussionsupporting

confidence: 87%

Cardiac chamber volumes and left ventricular mass in people living with HIV and matched uninfected controls

et al. 2020

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People living with HIV (PLWH) have increased risk of cardiovascular diseases compared with uninfected populations. We assessed structural cardiac abnormalities and their associated risk factors in well-treated PLWH and uninfected controls using multidetector computed tomography (MDCT). Methods People living with HIV and age-and sex-matched uninfected controls underwent MDCT to determine left atrial volume (LAV), left ventricular diastolic volume (LVDV), right ventricular diastolic volume (RVDV) and left ventricular mass (LVM). All outcomes were indexed to body surface area (BSA) (LAVi, LVDVi, RVDVi and LVMi). Results A total of 592 PLWH and 1184 uninfected controls were included in the study. PLWH had smaller mean (SD) LAVi [40 (8) vs. 41 (9) mL/m 2 ; P = 0.002] and LVDVi [61 (13) vs. 65 (14) mL/m 2 ; P < 0.001] but larger RVDVi [89 (18) vs. 86 (17) mL/m 2 ; P < 0.001] than uninfected controls. HIV was independently associated with 7 mL (95% CI: À10 to À3) smaller LVDV, and with 12 mL (95% CI: 8-16) larger RVDV, and 4 g (95% CI: 1-6) larger LVM after adjustment for cardiovascular risk factors and BSA. Large RVDV in PLWH was not associated with obstructive lung function. Conclusions HIV was independently associated with smaller LVDV and larger RVDV and LVM. Alterations in cardiac chamber volumes in PLWH were mainly minor. The clinical impact of these findings is uncertain, but it seems unlikely that alterations in cardiac chamber volumes explain the increased burden of cardiovascular disease previously observed in PLWH.

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Section: Discussionsupporting

confidence: 87%

Cardiac chamber volumes and left ventricular mass in people living with HIV and matched uninfected controls

et al. 2020

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“…Respiratory symptoms were more common in PLWH. Thus, as previously reported [3], 7.8 versus 4.1% reported dyspnoea (P < 0.0001), 17.5 versus 9.5% reported sputum production (P < 0.0001), 12.9 versus 6.8% reported chronic cough (P < 0.0001) and 22.0 versus 15.8% reported wheezing (P < 0.001) in PLWH and uninfected controls, respectively. Table 1 depicts the diagnostic performance of a combination of different clinical characteristics (i.e.…”

Section: Resultssupporting

confidence: 83%

“…The study design has been described elsewhere . PLWH and uninfected controls with spirometry from the Copenhagen Comorbidity in HIV Infection (COCOMO) study and Copenhagen General Population Study (CGPS), respectively, were recruited.…”

Section: Methodsmentioning

confidence: 99%

Diagnostic performance of clinical characteristics to detect airflow limitation in people living with HIV and in uninfected controls

et al. 2018

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“…All participants completed a comprehensive questionnaire about smoking and underwent a physical examination, including pre-bronchodilatory spirometry; details regarding data collection and procedures have previously been described. 13 Predicted values for FEV 1 and FVC were calculated according to the Global Lung Function Initiative (GLI). 14 Airflow limitation was defined spirometrically as FEV 1 /FVC <the lower limit of normal (LLN), calculated according to the GLI, and as FEV 1 /FVC >0.7.…”

Section: Methodsmentioning

confidence: 99%

Validation of lung density indices by cardiac CT for quantification of lung emphysema

Ronit¹,

Kristensen²,

Çolak³

et al. 2018

COPD

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ObjectivesCardiovascular disease is often associated with COPD. Lung density quantification of images obtained from cardiac computed tomography (CT) scans would allow simultaneous evaluation of emphysema and coronary artery calcification score and provide further mechanistic insight into the relationship between these syndromes.Patients and methodsWe assessed the agreement between lung density indices obtained by cardiac and full-lung CT scans. Paired cardiac and chest CT scans were assessed in 156 individuals with and without airflow limitation. Quantitative threshold indices of low attenuation area (LAA) and 15th percentile density index (PD15) were compared in terms of precision using Spearman’s correlation coefficient, accuracy using concordance correlation coefficient (CCC), and relative accuracy using P15 and P30. We also assessed the relationship between visually and quantitatively determined emphysema and used receiver operating characteristic curves to evaluate the ability of lung density indices to discriminate airflow limitation.ResultsCorrelation coefficients between lung density indices obtained from cardiac and chest CT scans were 0.49 for percent LAA (%LAA)-950 and 0.71 for PD15. Corresponding values for CCC, P15, and P30 were 0.33, 3.2, and 5.1, respectively, for %LAA-950, and 0.34, 17.3, and 37.8, respectively, for PD15. For both cardiac and chest CT scans, visually determined emphysema was associated with higher %LAA-950 and lower PD15, and the ability of %LAA-950 and PD15 to discriminate airflow limitation were comparable.ConclusionAlthough chest CT imaging is preferable, cardiac CT imaging may also be used for lung emphysema quantification where association measures are of primary interest.

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Airflow limitation in people living with HIV and matched uninfected controls

Abstract: NCT02382822.

Cited by 60 publications

References 41 publications

Cardiac chamber volumes and left ventricular mass in people living with HIV and matched uninfected controls

Cardiac chamber volumes and left ventricular mass in people living with HIV and matched uninfected controls

Diagnostic performance of clinical characteristics to detect airflow limitation in people living with HIV and in uninfected controls

Validation of lung density indices by cardiac CT for quantification of lung emphysema

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