Clinical and Echocardiographic Findings in HIV Patients with Pericardial Effusion

Abstract

Background and Objectives: Pericardial effusion (PE) is frequently found in patients infected with the human immunodeficiency virus (HIV), but its clinical significance remains unclear. Our purpose was to study the manifestations of HIV-infected patients with PE and the coexistence of these manifestations with other echocardiographic abnormalities, compared with patients without PE. Methods: We reviewed 141 HIV-infected patients in whom echocardiographic study was performed. We studied their epidemiological, clinical, hematological, immunological, electrocardiographic (ECG) and echocardiographic characteristics and their in-hospital outcome. Results: Patients with PE (n = 55), compared with those without PE (n = 86), were more often clinical stage C and immunological stage 3, had left-ventricular dysfunction and right-ventricular dilatation more frequently, and had been diagnosed as HIV-positive for a longer time. Seven patients with moderate to severe PE developed cardiac tamponade. Compared with patients with small PE (n = 34), those with moderate to large PE (n = 21), had pericardial rub, ECG repolarization abnormalities consistent with pericarditis, immunological stage 3, left-ventricular dysfunction and right-ventricular dilatation more frequently. In 3 patients, cardiac tamponade disappeared after anti-tuberculous therapy; in 3 cases, pericardial drainage was performed (anti-tuberculous therapy was not attempted); 1 patient with cardiac tamponade was not drainaged because he was a terminal patient with an extensive lymphoma. Conclusions: PE in HIV-infected patients is associated with (1) advanced stages of infection, and (2) left-ventricular dysfunction and right-ventricular dilatation; (3) presence of pericardial rub and ECG alterations consistent with pericarditis suggests the existence of moderate to large PE.

Study of cardiovascular manifestations in patients of HIV- its correlation with CD4 count and the ART regimen prescribed

“…Therefore the mean CD4 count of cases was much less in this study as compared to other studies. 17,18 Pericardial effusion was seen in 15.53% of cases which is as par with Indian studies done by Aggarwal et al and studies done at United States by Himelman et al 14,19 The pericardial effusion detected was often small in amount and without any hemodynamic significance. Pericardial effusion in HIV patients may be marker of end stage HIV infection because it is associated with very low CD4 count.…”

Cardiac involvement in HIV infected people in Yaounde, Cameroon

“…In contrast Moreno et al found that pericardial effusions were associated with advanced stages of the disease. 12 The association might have been obscured in our study by the relatively smaller sample. Of considerable clinical significance is the fact most pericardial effusions in our series were not clinically suspected.…”

“…HIV infection has been shown to be associated with endocardial, myocardial, and pericardial abnormalities. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] HIV associated myocarditis has been extensively studied with HIV virions detected in myocardial cells of HIV infected patients. 8 Many studies have shown that HIV is an important cause of dilated cardiomyopathy.…”

Study of Cardiac Manifestations in Patients with HIV Infection and Their Correlation with CD4 Count in Indian Population

“…[18] Reduction in ejection fraction without global hypokinesia or chamber enlargement but without any symptom probably represented a mild form of cardiac disease that will progress to a clinically evident form of dilated cardiomyopathy. [7] Dilated cardiomyopathy was seen in 9.25% of the cases whereas studies published by Moreno et al [19] and Hakim et al [20] had detected 6% and 5% respectively. Pulmonary artery hypertension was noted in 6 cases (11.1%) which was higher than normal population and comparable to studies done by Pellicelli et al [21] and Mehta et al [22] who also found higher incidence of pulmonary artery hypertension in HIV patients than normal population.…”