Pulmonary Hypertension Associated With HIV Infection

Almodóvar, Sharilyn; Cicalini, Stefania; Petrosillo, Nicola; Flores, Sonia C.

doi:10.1378/chest.09-3065

Cited by 44 publications

(32 citation statements)

References 46 publications

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“…Increased survival of HIV-infected patients with the advent of antiretroviral therapy has resulted in an increase in the prevalence of noninfectious complications including pulmonary arterial hypertension (42–44). Furthermore, illicit drug use has been identified as one of the most common risk factors in the individuals with HIV-associated PAH (9, 10, 43).…”

Section: Discussionmentioning

confidence: 99%

Macrophage‐derived extracellular vesicles mediate smooth muscle hyperplasia: role of altered miRNA cargo in response to HIV infection and substance abuse

Sharma¹,

Chinnappan²,

Agarwal³

et al. 2018

FASEB j.

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Our previous studies consistently demonstrate enhanced pulmonary vascular remodeling in HIV–infected intravenous drug users, and in simian immunodeficiency virus–infected macaques or HIV-transgenic rats exposed to opioids or cocaine. Although we reported an associated increase in perivascular inflammation, the exact role of inflammatory cells in the development of pulmonary vascular remodeling remains unknown. In this study, HIV–infected and cocaine (H+C)–treated human monocyte derived macrophages released a higher number of extracellular vesicles (EVs), compared to HIV-infected or uninfected cocaine-treated macrophages, with a significant increase in the particle size range to 100–150 nm. Treatment of primary human pulmonary arterial smooth muscle cells (HPASMCs) with these EVs resulted in a significant increase in smooth muscle proliferation. We also observed a significant increase in the miRNA-130a level in the EVs derived from H+C-treated macrophages that corresponded with the decrease in the expression of phosphatase and tensin homolog and tuberous sclerosis 1 and 2 and activation of PI3K/protein kinase B signaling in HPASMCs on addition of these EVs. Transfection of HPASMCs with antagomir-130a–ameliorated the EV-induced effect. Thus, we conclude that EVs derived from H+C-treated macrophages promote pulmonary smooth muscle proliferation by delivery of its prosurvival miRNA cargo, which may play a crucial role in the development of PAH.—Sharma, H., Chinnappan, M., Agarwal, S., Dalvi, P., Gunewardena, S., O’Brien-Ladner, A., Dhillon, N. K. Macrophage-derived extracellular vesicles mediate smooth muscle hyperplasia: role of altered miRNA cargo in response to HIV infection and substance abuse.

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Section: Discussionmentioning

confidence: 99%

Macrophage‐derived extracellular vesicles mediate smooth muscle hyperplasia: role of altered miRNA cargo in response to HIV infection and substance abuse

Sharma¹,

Chinnappan²,

Agarwal³

et al. 2018

FASEB j.

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“…RV dysfunction can result from PH, which has been associated with HIV infection (1, 2, 13,17). We therefore assessed the relationship of RV function to pulmonary artery pressures.…”

Section: Discussionmentioning

confidence: 99%

“…Human immunodeficiency virus (HIV) infection has been associated with many cardiac abnormalities including cardiomyopathy, pulmonary hypertension (PH), and coronary artery disease (1, 2, 3, 4). In contrast, the presence and nature of right ventricular (RV) abnormalities have not been extensively studied.…”

Section: Introductionmentioning

confidence: 99%

Isolated Right Ventricular Dysfunction in Patients With Human Immunodeficiency Virus

Simon

Lacomis

George

et al. 2014

Journal of Cardiac Failure

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BACKGROUND HIV-infected individuals are at increased risk for pulmonary hypertension and cardiomyopathy, portending a poor prognosis. Right ventricular (RV) dysfunction is associated with worse outcomes in these conditions, yet its prevalence is poorly defined in HIV. We sought to determine the prevalence of RV dysfunction in an outpatient HIV cohort. METHODS Echocardiograms were evaluated in 104 HIV-infected adults. Measurements included estimated pulmonary arterial systolic pressure (PAP) and several measures of RV function including tricuspid annular plane systolic excursion (TAPSE), RV longitudinal myocardial strain (RV LMS), RV fractional area change (RVFAC), and myocardial performance index (MPI). RESULTS Sixteen subjects (15%) had PAP>35 mm Hg, yet RV function did not differ significantly from those with normal estimated PAP. RV dysfunction defined by RVFAC < 35% occurred in 11%. RV LMS had a median value of −27.3% and individuals below the median had lower TAPSE, but no differences in LVEF, PAP, or other measures. Dyspnea was associated with the lowest quintile of RV LMS (≥−21.05%). There were 6 subjects with LVEF<50% and these individuals had lower TAPSE, but no difference PAP or other RV functional measures. CONCLUSIONS RV dysfunction was as common as estimated PAP>35 mm Hg and LV dysfunction, but these findings did not co-segregate. RV dysfunction in HIV-infected individuals may be a separate entity from LV/global cardiomyopathy or pulmonary hypertension and deserves further study.

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“…2 Pulmonary artery hypertension associated with HIV infection (HIV-PAH) has been documented at all stages of the disease and its manifestations range from asymptomatic right ventricular dysfunction to overt right heart failure. 2 Children with HIV infection may develop this complication.…”

Section: Pulmonary Arterial Hypertension (Pah)mentioning

confidence: 99%

Pulmonary Artery Hypertension Associated with HIV Infection in Nine Year-Old Child

Prabowo

Wahab

Mumpuni

2018

Acta Cardiol Indones

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Pulmonary arterial hypertension (PAH) is a serious life threatening and severe complication of HIV infection. A PAH presentation in patient with HIV tends to non specific, result in recognized diagnosis at a later stage. A 9 year-old HIV patient came to Pediatric Clinic with a chief complaint of worsening dyspneu for 1 month, leg edema and difficulty lying on a flat bed. Patient showed signs and symptoms that lead to pulmonary hypertension. An ECG findings were sinus rhythm, right axis deviation, and right ventricular hypertrophy. Echocardiography findings showed right ventricular and atrial enlargement, and high probability of pulmonary hypertension. Blood examination showed CD 4 was 84 cells/µL. The patient was managed as pulmonary artery hypertension associated with HIV (HIV-PAH) infection.The patient was admitted for 3 weeks and eventually discharged with relieve condition.

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Pulmonary Hypertension Associated With HIV Infection

Cited by 44 publications

References 46 publications

Macrophage‐derived extracellular vesicles mediate smooth muscle hyperplasia: role of altered miRNA cargo in response to HIV infection and substance abuse

Macrophage‐derived extracellular vesicles mediate smooth muscle hyperplasia: role of altered miRNA cargo in response to HIV infection and substance abuse

Isolated Right Ventricular Dysfunction in Patients With Human Immunodeficiency Virus

Pulmonary Artery Hypertension Associated with HIV Infection in Nine Year-Old Child

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