Evaluation of Human Immunodeficiency Virus Infection‐Related Left Ventricular Systolic Dysfunction by Tissue Doppler Strain Echocardiography

Onur, Imran; İkitimur, Barış; Öz, Fahrettin; Ekmekçi, Ahmet; Elıtok, Ali; Çağatay, Arif Atahan; Adalet, Kâmil; Bilge, Ahmet Kaya; Kaya, Fatih

doi:10.1111/echo.12569

Cited by 9 publications

(9 citation statements)

References 33 publications

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“…In the era of widespread use of antiretroviral (ARV) therapy for human immunodeficiency virus (HIV) infection, reports of higher than expected rates of systolic and diastolic dysfunction persist [1][2][3][4][5]. A recent meta-analysis of studies evaluating cardiac dysfunction during HIV infection in the context of ARV therapy identified left ventricular (LV) systolic dysfunction in 8% and diastolic dysfunction in as many as 43% of HIV-infected adults [1].…”

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confidence: 99%

Abnormal Myocardial Function Is Related to Myocardial Steatosis and Diffuse Myocardial Fibrosis in HIV-Infected Adults

Liu²,

et al. 2015

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HIV-infected adults have reduced myocardial function as compared to controls in the absence of known CVD. Decreased cardiac function was associated with abnormal myocardial tissue composition characterized by increased lipid levels and diffuse myocardial fibrosis. Metabolic alterations related to antiretroviral therapy and chronic inflammation may be important targets for optimizing long-term cardiovascular health in HIV-infected individuals.

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confidence: 99%

Abnormal Myocardial Function Is Related to Myocardial Steatosis and Diffuse Myocardial Fibrosis in HIV-Infected Adults

Liu²,

et al. 2015

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“…Our study evaluate the relationship of LV function with GLS in HIV patients to baseline CD4 count, HIV viral Load, duration of HIV diagnosis, HAART therapy and HAART therapy duration showed patients with CD4 count less than 300 cell/mm 3 had significantly lower GLS value less than -18% compared with higher CD4 count. Previous study done by Onur et al 18 and Karavidas et al 19 found no relationship between CD4 T-cells and systolic strain. But later study done by Cetin et al 16 showed positive correlation between reduced CD4 count and GLS value, though there were no significant difference between different CD4 level group below and greater than 300.…”

Section: Discussionmentioning

confidence: 78%

“…The main analysis of the present study showed that asymptomatic HIV-infected patients without cardiovascular disease had significantly lower GLS value despite having normal LV systolic function compared to the that of healthy individuals which were similar to previous study done by Mendes et al 15 and Cetin et al 16 . There were also very few study done with Doppler/TDI strain imaging and strain rate done by Sims A et al 17 , Onur et al 18 and Karavidas et al 19 which all have demonstrated impaired strain and strain rate despite having normal systolic function in HIV patients compared to the healthy control group.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of left ventricular systolic function by Myocardial Deformation Imaging in asymptomatic HIV patients

et al. 2019

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Background and Aims: Despite improvements in clinical care, evidence from both industrialized and developing countries indicates that the prevalence of subclinical cardiac dysfunction in individuals with well-controlled HIV infection may approach 50% and represent a newly recognized comorbid condition. The aim of our study was to reveal abnormalities in cardiac function using conventional transthoracic echocardiography and left ventricular strain imaging in HIV infected patients without cardiovascular disease. Methods: This was a hospital based, single center descriptive cross-sectional comparative study conducted in National Academy of Medical Sciences (NAMS), Bir Hospital which included HIV patients with baseline examination including a patient medical history, clinical examination, baseline CD4 count, viral load and a standardized transthoracic echocardiography and strain imaging examination and the findings were compared among age and sex frequency matched healthy adult population. Results: Our study enrolled 142 patients out of which 95 HIV positive patients (mean age 36.7±9.2 years with 58% female) and 47 healthy control (mean age 33.7±8 years with 57.4% female). The median duration of HIV diagnosis was 7 years (IQR 2, 10) and median CD4 count was 464 cells/mm3 (IQR 259,750). There was no significant difference in conventional echocardiographic parameters between two groups except for transmitral E velocity that was lower in HIV group (P value of 0.001). The HIV population has lower mean global longitudinal strain (GLS) value of -19.92% ± 2.54 SD compared to the healthy control population with mean of -21.39% ± 1.54 SD(P value of 0.001) and patients with CD4 count less than 300 cell/mm3 had GLS value significantly lower than -18% (P value of 0.05). Conclusion: HIV infected population without established cardiovascular disease have subclinical left ventricular dysfunction revealed by GLS imaging technique.

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“…Heart failure remains a significant problem in HIV infected patients; the incidence of HIV/AIDS related heart failure is on increase, and current evidence suggests that diastolic, rather than systolic dysfunction is the predominant form of heart failure in the era of ART [14,15]. Risk factors for systolic dysfunction included elevated high-sensitivity C-reactive protein, tobacco use and prior myocardial infarction (MI); for diastolic dysfunction, risk factors were hypertension and older age [16][17][18]. In 2242 HIV infected patients on ART from 11 contemporaneous studies, systolic and diastolic dysfunction were in 8.3% and 43.4% of study subject, respectively [16].…”

Section: Heart Failurementioning

confidence: 99%

HIV-Associated Cardiovascular Disease

Saad¹,

Ntusi²

2018

Advances in HIV and AIDS Control

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Currently, 17 million people worldwide are receiving antiretroviral therapy (ART) for human immunodeficiency viral (HIV) infection. There has been a dramatic decline in mortality from HIV infection in the last decade due to increased availability of ART. HIVassociated cardiac failure is on the increase, with more cases of diastolic dysfunction reported in the ART era. HIV increases the risk of CVD, because of longer survival on ART, ongoing subclinical inflammation, traditional cardiovascular risk factors and the complications of chronic ART use. HIV-associated CVD encompasses a wide spectrum of heterogeneous clinical entities, which include diastolic dysfunction, asymptomatic left ventricular dysfunction, cardiomyopathy, myocarditis, heart failure, myocardial fibrosis, myocardial steatosis, pulmonary hypertension, peripheral arterial disease, cerebrovascular disease, infective endocarditis, coronary artery disease and cardiac neoplasms (e.g. Kaposi sarcoma and B-cell immunoblastic lymphoma). In this chapter, we review the complex association of HIV infection and CVD. We describe important recent developments and perspectives based on a systematic analysis of the important advances in this field published in the last decade.

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Evaluation of Human Immunodeficiency Virus Infection‐Related Left Ventricular Systolic Dysfunction by Tissue Doppler Strain Echocardiography

Abstract: Left ventricular systolic strain parameters may be utilized to demonstrate subtle LV systolic dysfunction in asymptomatic HIV patients.

Cited by 9 publications

References 33 publications

Abnormal Myocardial Function Is Related to Myocardial Steatosis and Diffuse Myocardial Fibrosis in HIV-Infected Adults

Abnormal Myocardial Function Is Related to Myocardial Steatosis and Diffuse Myocardial Fibrosis in HIV-Infected Adults

Evaluation of left ventricular systolic function by Myocardial Deformation Imaging in asymptomatic HIV patients

HIV-Associated Cardiovascular Disease

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