[Cardiac involvement within the scope of HIV-1 infection: preliminary results of echocardiography study].
The results of one- and two-dimensional echocardiography in 128 patients (117 males, 11 females; median age 37 years) who were seropositive for HIV-1 were analyzed in addition to clinical, electrocardiographic, and laboratory data. Follow-up controls are available for 51 patients over an observation period of 1 to 24 months, median 9.5 months. Probably HIV-related echocardiographic abnormalities were identified in 36 patients (28%): small to moderate pericardial effusions (n = 34) and left ventricular dilation (n = 5). Pericardial effusions resolved in seven patients during follow-up, in three cases after tuberculostatic chemotherapy. Compared to patients without cardiac involvement patients with HIV-related echocardiographic abnormalities showed lower CD4-lymphocyte counts (143 +/- 138 vs 289 +/- 219/microliters, p less than or equal to 0.01), and left ventricular endsystolic dimensions were increased (34.2 +/- 4.5 vs 32.6 +/- 3.0 mm, p less than or equal to 0.05). Cardiac involvement occurred predominantly in the advanced stages of the HIV-1 infection with unclear etiology in the majority of cases, even though active concomitant diseases could be frequently demonstrated. The clinical course of some patients might be consistent with intercurrently completed perimyocarditis, probably of viral genesis. CD4-lymphocyte counts less than or equal to 100/microliters could be identified as a risk factor for the development of cardiac manifestations. The significance of a demonstrated involvement of the heart with regard to therapeutic consequences and prognosis appeared to be slight. Use of echocardiography as a routine method for the detection of cardiac involvement in HIV-1 infection has proved to be valuable, since indicative clinical symptoms were lacking in almost all cases.
Steffen
H M
HM
Medizinische Klinik II, Universität Köln.
Schrappe-Bächer
M
M
Müller
R
R
Salzberger
B
B
Fätkenheuer
G
G
Geisler
S
S
Degenhardt
S
S
Griebenow
R
R
D000328:Adult; D000368:Aged; D004452:Echocardiography; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis; D006679:HIV Seropositivity / Q000150:complications; D015497:HIV-1 / Q000472:pathogenicity*; D006331:Heart Diseases / Q000150:complications* / Q000175:diagnosis; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D009894:Opportunistic Infections / Q000150:complications
Kardiale Beteiligung im Rahmen der HIV-1-Infektion: Vorläufige Ergebnisse einer echokardiographischen Untersuchung.