title: Doppler tissue imaging unmasks right ventricular function abnormalities in HIV-infected patients.
abstract: BACKGROUND
  We sought to investigate right ventricular (RV) function with Doppler tissue imaging (DTI) in human immunodeficiency virus (HIV)-infected patients receiving highly-active antiretroviral treatment, without any heart-related symptoms.
  
  
  METHODS
  We studied 38 asymptomatic HIV patients (aged 44.5 ± 9.2 years, 22 of them men) and 25 age-matched and sex-matched controls. All subjects underwent conventional and DTI estimation of left ventricular (LV) systolic and diastolic function, measuring peak systolic and diastolic myocardial velocities at the mitral annulus (Sm, Em, Am). Two-dimensional (2-D) echocardiographic study of the right ventricle (RV) was performed from the four-chamber view, and RV end-diastolic dimensions were measured. DTI recordings from the RV free wall at the tricuspid annulus were used to determine systolic (SmRV) and diastolic function (EmRV and AmRV).
  
  
  RESULTS
  HIV-infected patients compared to controls exhibited significantly lower peak systolic velocities at the septal-SmIVS (7.9 ± 1.3 vs 9.1 ± 1.4 cm/s, p = 0.002) and lateral mitral annulus - SmLAT (9.8 ± 1.7 vs 11.2 ± 1.3 cm/s, p = 0.025); no difference was observed regarding conventional 2-D examination of LV systolic and diastolic function and DTI-derived Em and Am. No significant difference occurred between HIV patients and controls regarding RV end-diastolic dimensions and pulmonary artery systolic pressure. However, SmRV (13.8 ± 1.6 vs 14.9 ± 2.2 cm/s, p = 0.040), EmRV (11.6 ± 3 vs 13.5 ± 2.6 cm/s, p = 0.028) and AmRV (10.9 ± 2.5 vs 13.8 ± 4 cm/s, p = 0.003) were significantly reduced in HIV patients as compared to controls.
  
  
  CONCLUSIONS
  DTI unmasks subtle and otherwise undetectable abnormalities of the longitudinal LV systolic function and both RV systolic and diastolic function, in asymptomatic HIV patients receiving highly-active antiretroviral treatment.
authors.affiliation: Department of Cardiology, Athens General Hospital, Greece.
authors.forename: Apostolos
authors.initials: A
authors.lastname: Karavidas
authors.forename: Dimitris
authors.initials: D
authors.lastname: Tsiachris
authors.forename: George
authors.initials: G
authors.lastname: Lazaros
authors.forename: George
authors.initials: G
authors.lastname: Xylomenos
authors.forename: Sophia
authors.initials: S
authors.lastname: Arapi
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Potamitis
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Matzaraki
authors.forename: John
authors.initials: J
authors.lastname: Caplanis
authors.forename: Evangelos
authors.initials: E
authors.lastname: Matsakas
authors.forename: Panos
authors.initials: P
authors.lastname: Gargalianos
authors.forename: Vlassis
authors.initials: V
authors.lastname: Pyrgakis
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D015150:Echocardiography, Doppler; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D006115:Greece; D015658:HIV Infections / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013997:Time Factors; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right; D055815:Young Adult