[Diastolic dysfunction in human immunodeficiency virus infection].
OBJECTIVE
We sought to determine the prevalence and characteristics of echocardiographic abnormalities (systolic and/or diastolic dysfunction, pericardial effusion) in patients with human immunodeficiency virus infection (HIV) with no symptoms or previous history of cardiac disease, and compare them with a healthy control group.


METHODS
Transthoracic echocardiography was performed in 125 patients (73% male, mean age 33.2 +/- 6.6 years) with HIV infection without cardiac involvement and 47 age and sex-matched healthy volunteers (78% male, 31.6 +/- 7.3 years). The immunologic situation was determined by CD4 lymphocyte counts.


RESULTS
Abnormal left ventricular relaxation and filling patterns (E/A relation 1.31 +/- 0.35 in HIV group, 1.66 +/- 0.38 in control group, p < 0.001; pressure half-time 57.5 +/- 13 in HIV group, 50.6 +/- 6.6 in control group, p < 0.001), segmental wall-motion abnormalities (15%) and pericardial effusion (7.2%) were found in patients with HIV infection. Systolic function (EF 64.8 +/- 8.3) and left ventricular dimension (diastolic diameter 4.94 +/- 0.55, systolic diameter 3.17 +/- 0.51) showed normal patterns and did not significantly differ from those of the control group.


CONCLUSIONS
Silent echocardiographic abnormalities in patients with HIV infection are frequent suggesting a direct myocardial effect of the virus. The development of diastolic dysfunction is directly related to a worse immunologic situation. Prospective studies are needed to clarify the clinical prognosis of these asymptomatic abnormalities.
Hernández Hernández
F
F
Servicio de Cardiología.Hospital Universitario 12 de Octubre, Madrid, Spain. fhernandezh@medynet.com
Gascueña Rubia
R
R
Escribano Subías
P
P
Velázquez Martín
M T
MT
Lombera Romero
F
F
Rubio García
R
R
Pulido Ortega
F
F
Ramón Costa Pérez-Herrero
J
J
Sáenz De La Calzada
C
C
D000328:Adult; D016022:Case-Control Studies; D004452:Echocardiography; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008297:Male; D009200:Myocardial Contraction; D011446:Prospective Studies; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000503:physiopathology