Congestive Cardiomyopathy in Association with the Acquired Immunodeficiency Syndrome

Cohen, Ira S.; Anderson, David W.; Virmani, Renu; Reen, Bernard M.; Macher, Abe M.; Sennesh, Joel; DiLorenzo, Paul; Redfield, Robert

doi:10.1056/nejm198609043151007

Cited by 216 publications

(64 citation statements)

References 16 publications

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“…Indeed, left ventricular dysfunction, seen even in asymptomatic HIV-1 carriers, 61 is among the most frequently described cardiac disorders in AIDS. 20,62 The gross and the histological cardiac abnormalities noted in these CD4C/HIV Tg mice are also similar to those observed in HIV-1 infection. Myofibrillar necrosis sometimes accompanied by a myocarditis, or myocarditis alone are commonly observed in human AIDS.…”

Section: Novel Observations In the Cd4c/hiv Tg Model Of Aids: Cardiovsupporting

confidence: 71%

“…13 Cardiac disease in AIDS was under-appreciated early in the course of the epidemic, but is now recognized as one of the most frequent complications of infection with HIV-1. [13][14][15][16][17][18][19] First described in 1986 by Cohen and colleagues, 20 the disease is characterized by a progressive, dilated cardiomyopathy that may be accompanied by a compensatory cardiac hypertrophy 21 as well as functional loss. 21 Histologically, a variety of lesions are observed, the most common being cardiomyocyte necrosis, often with fibrosis.…”

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confidence: 99%

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Cardiac Disease in Transgenic Mice Expressing Human Immunodeficiency Virus-1 Nef in Cells of the Immune System

Kay

Yue

Hanna

et al. 2002

The American Journal of Pathology

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We previously reported that a severe acquired immune deficiency syndrome-like disease develops in transgenic (Tg) mice expressing the human immunodeficiency virus-1 in its natural target cells: immature and mature CD4 ؉ T cells and cells of the macrophage/ dendritic lineage. Here, we show that these mice also develop cardiac disease, characterized most prominently by a focal myocytolysis, occasionally by myocarditis and by deposition of endogenous immunoglobulin on cardiomyocytes. Microfil perfusion demonstrated widespread coronary arteriospasm and echocardiographic analysis revealed depressed cardiac function in Tg mice. A higher (but still modest) level of cardiomyocyte apoptosis was detected in Tg as compared to non-Tg hearts. Tg expression was detected in some of the infiltrating mononuclear cells, but not in cardiomyocytes or in cells of the heart vessels, suggesting a human immunodeficiency virus-1-induced disease process mediated by cells of the immune system. The similarity of the heart disease observed in these Tg mice to that observed in acquired immune deficiency syndrome patients suggests a common pathogenesis.

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Section: Novel Observations In the Cd4c/hiv Tg Model Of Aids: Cardiovsupporting

confidence: 71%

mentioning

confidence: 99%

Cardiac Disease in Transgenic Mice Expressing Human Immunodeficiency Virus-1 Nef in Cells of the Immune System

Kay

Yue

Hanna

et al. 2002

The American Journal of Pathology

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“…One consequence of the increased survival is the emergence of new manifestations of HIV infection, including cardiac dysfunction. [1][2][3][4][5][6][7] Dilated cardiomyopathy and associated symptoms of congestive heart failure are being recognized with increasing frequency, with estimates that 10% to 18% of HIV seropositive individuals will manifest evidence of left ventricular dysfunction giving rise to 21 000 to 40 000 new cases of symptomatic heart failure each year by the year 2000. Despite this clinical recognition, the pathogenesis of HIV cardiomyopathy remains unclear, limiting application of both specific treatments and preventive strategies.…”

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confidence: 99%

Dilated Cardiomyopathy Associated With Simian AIDS in Nonhuman Primates

et al. 2000

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Background-Cardiomyopathy is being recognized with increasing frequency in patients with AIDS, yet the relationship between HIV infection and cardiac contractile dysfunction remains obscure. The purpose of the present study was to determine if infection with simian immunodeficiency virus (SIV) in nonhuman primates is associated with cardiac dysfunction and myocardial injury. Methods and Results-Left ventricular size and function were determined by 2D echocardiography in 16 rhesus macaques before and at weekly intervals following infection with cloned pathogenic SIV mac 239 or the highly attenuated SIV mac 239 nef deletion mutant. A second group of 15 rhesus macaques chronically infected with pathogenic (nϭ6) or nonpathogenic (nϭ9) virus were studied at Ͼ2 years following infection. Cardiac tissues from 24 rhesus macaques chronically infected (Ͼ2 years) with pathogenic SIV were reviewed for evidence of cardiac pathology. Acute infection (Ͻ6 weeks) with either pathogenic or nonpathogenic SIV caused neither contractile dysfunction nor cardiac pathology. However, LV ejection fraction was significantly (PϽ0.05) depressed (43Ϯ7%) in rhesus macaques chronically infected with pathogenic SIV compared with rhesus macaques chronically infected with nonpathogenic SIV (61Ϯ3%). Furthermore, two thirds of rhesus macaques that succumbed to simian AIDS had myocardial pathology including lymphocytic myocarditis (nϭ9) and coronary arteriopathy (nϭ6), with complete vessel occlusion (nϭ4) and associated myocardial infarction and necrosis. Conclusions-This unique model is valuable in understanding the pathogenesis of cardiac injury associated with retroviral infection in a relevant nonhuman primate model of AIDS.

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“…In patients with AIDS, although mucocutaneous Candida infection is very common, dissemination of such infections is rare [2]. This case illustrates, however, that congestive cardiomyopathy in association with AIDS is not limited to myocardial Kaposi's sarcoma [4] or HIV myocarditis [5] but may also be a fatal complication of an opportunistic fungal infection. The condition of this patient indicates that in the differential diagnosis of fulminant hepatitis, the possibility of HSV dissemination complicating previously unrevealed HIV infection should be considered.…”

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confidence: 86%

Disseminated Herpes Simplex Type 2 and Systemic Candida Infection in a Patient with Previous Asymptomatic Human Immunodeficiency Virus Infection

Zimmerli

Bianchi

Gudat

et al. 1988

Journal of Infectious Diseases

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Congestive Cardiomyopathy in Association with the Acquired Immunodeficiency Syndrome

Cited by 216 publications

References 16 publications

Cardiac Disease in Transgenic Mice Expressing Human Immunodeficiency Virus-1 Nef in Cells of the Immune System

Cardiac Disease in Transgenic Mice Expressing Human Immunodeficiency Virus-1 Nef in Cells of the Immune System

Dilated Cardiomyopathy Associated With Simian AIDS in Nonhuman Primates

Disseminated Herpes Simplex Type 2 and Systemic Candida Infection in a Patient with Previous Asymptomatic Human Immunodeficiency Virus Infection

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