Right and left ventricular cardiac function in a developed world population with human immunodeficiency virus studied with radionuclide ventriculography.
BACKGROUND
Cardiac dysfunction has been reported in a substantial part of patients infected with the human immunodeficiency virus (HIV). However, most studies are from a time before the introduction of highly active antiretroviral treatment (HAART), which has significantly reduced HIV-associated morbidity and mortality rates. Accordingly, the prevalence of HIV-associated cardiac dysfunction may also have changed. The aim of the study was to establish the prevalence of right- and left-sided cardiac dysfunction in a Danish HIV population, most of whom were undergoing HAART, with radionuclide ventriculography.


METHODS
Ninety-five consecutive patients with HIV infection were included. Mean HIV duration was 104 months, and 84% of the patients received HAART. All patients underwent radionuclide ventriculography, and plasma levels of atrial natriuetic peptide (ANP), brain natriuetic peptide (BNP), and endothelin-1 (ET-1) were measured. Thirty age- and sex-matched healthy volunteer subjects were included to establish reference values of radionuclide measurements of left and right ventricular ejection fraction and of left ventricular volume.


RESULTS
Of 95 patients with HIV, 1 (1%) had a reduced left ventricular ejection fraction and 6 (7%) had a reduced right ventricle ejection fraction (0.35-0.42) compared with reference values from the age- and sex-matched reference population. Patients with HIV and reduced cardiac function did not differ in the duration of HIV, CD4 count, CD4 nadir, or HIV RNA load. No correlations were found between reduced cardiac function and levels of the 3 peptides measured.


CONCLUSIONS
No major dysfunction of the left ventricle is present in a developed world HIV population. However, a small but significant part of this population has modestly reduced right-sided systolic function.
Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark. lebech@dadlnet.dk
Anne-Mette
AM
Lebech
Jan
J
Gerstoft
Birger
B
Hesse
Claus Leth
CL
Petersen
Andreas
A
Kjaer
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D009320:Atrial Natriuretic Factor / Q000097:blood; D003718:Denmark; D019049:Developed Countries; D019332:Endothelin-1 / Q000097:blood; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D015635:Radionuclide Ventriculography; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging*
D019332:Endothelin-1; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor