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

Abstract

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.

Diastolic dysfunction in people with HIV without known cardiovascular risk factors in Western Kenya

“…Despite the low prevalence of DD, PLWH in this study had higher LV mass consistent with previous echocardiogram13 21 and CT43 44 studies. In a relatively young cohort (mean age of 43 years) without history of hypertension, it is interesting to note early development of increases in LV mass potentially suggesting the role of HIV infection in the pathogenesis of these early subclinical changes.…”

Asymptomatic people with well-controlled HIV do not have abnormal left ventricular global longitudinal strain

“…This is in contrast to some other studies who reported a higher prevalence of abnormal GLS, and cardiac dysfunction ( 11 , 28 , 35 ), but these studies were retrospective analyses of echocardiograms performed in people referred for assessment, suggesting a biased potentially symptomatic population. The studies in prospectively recruited cohorts with or without HIV-negative control groups were less likely to report clinically significant changes in GLS and other parameters of cardiac function ( 17 , 29 ).…”

“…In this study, HIV was independently associated with minor reductions in LV diastolic volume. The minor differences in RV diastolic volume and LV mass were no longer significant after controlling for BSA ( 17 ). Pulmonary hypertension is also well recognised as a complication of poorly controlled HIV and ART use ( 18 , 19 ).…”

The Interplay between Adipose Tissue Properties and Levels of NT-proBNP in People with HIV

“…Te endocardial borders were manually traced on 15-20 tomographic slices, depending on the size of the atrial chamber. Te left atrial appendage was included in the measurement, while the pulmonary veins were meticulously excluded from the assessment of the atrial cavity [28]. LA volume index (LAVi) was calculated by dividing LA volume with body surface area (BSA), which was calculated from the Du Bois formula as follows: weight(kg) 0.425 × height(cm) 0.725 􏽨 􏽩 × 0.007184.…”