Relationships Among HIV Infection, Metabolic Risk Factors, and Left Ventricular Structure and Function

Abstract

Our objective was to determine if the presence of metabolic complications (MC) conveyed an additional risk for left ventricular (LV) dysfunction in people with HIV. HIV⁺ and HIV⁻ men and women were categorized into four groups: (1) HIV⁺ with MC (43±7 years, n=64), (2) HIV⁺ without MC (42±7 years, n=59), (3) HIV⁻ with MC (44±8 years, n=37), or (4) HIV⁻ controls without MC (42±8 years, n=41). All participants underwent two-dimensional (2-D), Doppler, and tissue Doppler echocardiography. Overall, the prevalence of systolic dysfunction (15 vs. 4%, p=0.02) and LV hypertrophy (9 vs. 1%, p=0.03) was greater in HIV⁺ than in HIV⁻ participants. Participants with MC had a greater prevalence of LV hypertrophy (10% vs. 1%). Early mitral annular velocity during diastole was significantly (p<0.005) lower in groups with MC (HIV⁺/MC⁺: 11.6±2.3, HIV⁻/MC⁺: 12.0±2.3 vs. HIV⁺/MC⁻: 12.4±2.3, HIV⁻/MC⁻: 13.1±2.4 cm/s) and tended to be lower in groups with HIV (p=0.10). However, there was no interaction effect of HIV and MC for any systolic or diastolic variable. Regardless of HIV status, participants with MC had reduced LV diastolic function. Although both the presence of MC and HIV infection were associated with lower diastolic function, there was no additive negative effect of HIV on diastolic function beyond the effect of MC. Also, HIV was independently associated with lower systolic function. Clinical monitoring of LV function in individuals with metabolic risk factors, regardless of HIV status, is warranted.

Physical Activity Affects Brain Integrity in HIV+ Individuals

“…To date, most studies of PA in HIV + individuals have focused on changes in body morphology and metabolism (Cade et al, 2013, 2008; Yarasheski et al, 2012, 2011). Only a few have investigated relationships between PA and cognition (Cade et al, 2013; Dufour et al, 2013; Fazeli et al, 2014; Gomes-Neto, Conceicao, Oliveira Carvalho, & Brites, 2013).…”

“…To date, most studies of PA in HIV+ individuals have focused on changes in body morphology and metabolism (Cade et al, 2013, 2008; Yarasheski et al, 2012, 2011). Only a few have investigated relationships between PA and cognition (Cade et al, 2013; Dufour et al, 2013; Fazeli et al, 2014; Gomes-Neto, Conceicao, Oliveira Carvalho, & Brites, 2013). Two studies reported a positive correlation between PA and cognition in HIV+ individuals, however, PA was defined as any activity that increased heart rate over the previous 72 hr (Dufour et al, 2013; Fazeli et al, 2014).…”