Prevalence and natural history of heart failure in outpatient HIV-infected subjects: rationale and design of the HIV-HEART study.
BACKGROUND
HIV infection is a global public health issue that is frequently associated with cardiac involvement. However, myocardial dysfunction and heart failure are often clinically occult or attributed incorrectly to other non-cardiac disease processes even a heightened awareness and knowledge for these cardiac diseases in HIV-infected patients may lead to earlier detection and a reduction in morbidity and mortality. The present study evaluates the frequency and clinical course of myocardial dysfunction and heart failure in a HIV-infected population.


METHODS
The HIV-HEART (HIV-infection and HEART disease) study is a prospective, long-term cohort study. The study is designed and powered to define prevalence and natural history of chronic heart failure. Following a pilot-study of 105 HIV-infected subjects the HIV-HEART trial will contain 802 HIV-infected males and females with and without antiretroviral therapy in an urban population. HIV-HEART is performed by using non-invasive techniques for the quantification of exercise intolerance and ventricular dysfunction, including concentration of B-type natriretic peptide (BNP), transthoracal echocardiography and endurance testing. Patients with BNP >100 pg/ml achieve a magnetic resonance tomography of the heart for characterization of myocardial dysfunction and type of cardiomyopathy. To determine incidence and natural history of myocardial dysfunction and heart failure, a 2 year follow-up started in September 2006.


CONCLUSIONS
The HIV-HEART study will define the significance of myocardial dysfunction and heart failure in a HIV-infected urban population and classify appropriate methods for identifying high-risk patients, the basis for risk stratification and therapy.
Neumann
Till
T
Department of Cardiology, University of Duisburg-Essen, Medical School, Hufelandstr. 55, 45122 Essen, Germany. till.neumann@uk-essen.de
Esser
Stefan
S
Potthoff
Anja
A
Pankuweit
Sabine
S
Neumann
Anja
A
Breuckmann
Frank
F
Neuhaus
Katrin
K
Kondratieva
Jana
J
Buck
Thomas
T
Müller-Tasch
Thomas
T
Wachter
Rolf
R
Prettin
Christiane
C
Gelbrich
Götz
G
Herzog
Wolfgang
W
Pieske
Burkert
B
Rauchhaus
Mathias
M
Löffler
Markus
M
Maisch
Bernhard
B
Mügge
Andreas
A
Wasem
Jürgen
J
Gerken
Guido
G
Brockmeyer
Norbert H
NH
Erbel
Raimund
R
D001795:Blood Pressure Determination; D002303:Cardiac Output, Low / Q000175:diagnosis* / Q000453:epidemiology*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D015995:Prevalence