Cardiac dysfunction in patients seropositive for the human immunodeficiency virus.
To confirm the presence of cardiac dysfunction in a group of patients seropositive for the human immunodeficiency virus with either dyspnea on exertion or a reduced anaerobic threshold, 9 patients with no history of opportunistic infection underwent exercise right-sided heart catheterization. When compared with 13 control patients previously exercised in the same manner, the patients showed elevated exercise pulmonary capillary wedge pressure (14.6 +/- 3.3 mm of mercury versus 9.9 +/- 3.3 mm of mercury; P less than .005) and right atrial pressure (10.1 +/- 2.1 mm of mercury versus 4.7 +/- 3.2 mm of mercury; P less than .001) at a similar exercise oxygen consumption and cardiac index. Of the 9 patients, 8 had at least 1 catheterization value outside the 95% confidence limits for the control group and 4 patients had multiple abnormalities. Values for blood CD4 lymphocytes were 0.2 x 10(9) per liter or more for 7 of the 9. One patient underwent endomyocardial biopsy with findings consistent with a cardiomyopathy. We conclude that cardiac disease may occur at any immunologic stage of human immunodeficiency virus infection. These observations suggest an effect of this disease on the heart.
Johnson
J E
JE
Pulmonary Disease/Critical Care Service, Brooke Army Medical Center, Fort Sam Houston, Texas 78234-6200.
Slife
D M
DM
Anders
G T
GT
Bailey
S R
SR
Blanton
H M
HM
McAllister
C K
CK
Latham
R D
RD
D000328:Adult; D001706:Biopsy; D006328:Cardiac Catheterization; D004562:Electrocardiography; D005080:Exercise Test; D006679:HIV Seropositivity / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D006321:Heart / Q000503:physiopathology*; D006331:Heart Diseases / Q000150:complications; D006439:Hemodynamics; D006801:Humans; D008297:Male; D009206:Myocardium / Q000473:pathology