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.
Department of Cardiology, University of Duisburg-Essen, Medical School, Hufelandstr. 55, 45122 Essen, Germany. till.neumann@uk-essen.de
Till
T
Neumann
Stefan
S
Esser
Anja
A
Potthoff
Sabine
S
Pankuweit
Anja
A
Neumann
Frank
F
Breuckmann
Katrin
K
Neuhaus
Jana
J
Kondratieva
Thomas
T
Buck
Thomas
T
Müller-Tasch
Rolf
R
Wachter
Christiane
C
Prettin
Götz
G
Gelbrich
Wolfgang
W
Herzog
Burkert
B
Pieske
Mathias
M
Rauchhaus
Markus
M
Löffler
Bernhard
B
Maisch
Andreas
A
Mügge
Jürgen
J
Wasem
Guido
G
Gerken
Norbert H
NH
Brockmeyer
Raimund
R
Erbel
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