title: Left ventricular remodelling in asymptomatic HIV infection on chronic HAART: comparison between hypertensive and normotensive subjects with and without HIV infection.
abstract: The high cardiovascular risk of HIV infected (HIV+) patients is still partly unexplained. We aimed to evaluate if HIV infection and highly active antiretroviral therapy (HAART) are linked per se to left ventricular (LV) remodelling, independently of blood pressure (BP) values. We enrolled 4 groups of patients matched by gender, age, body mass index and smoking habit: 30 HIV+ hypertensives, 30 HIV+ normotensives, 30 not-infected (HIV-) hypertensives and 30 HIV- normotensives. HIV+ patients were on chronic HAART. Hypertension was newly diagnosed (≤6 months) and never treated. Each patient underwent blood tests, 24-h BP monitoring and LV echocardiogram. The 4 groups had similar fasting glucose and cholesterol; triglycerides, HOMA index and prevalence of metabolic syndrome were higher in the HIV+ groups. Despite similar 24-h BP values, HIV+ hypertensives had greater LV mass and higher prevalence of preclinical diastolic dysfunction than HIV- hypertensives. Compared to HIV- normotensives, HIV+ normotensives had similar 24-h BP values, but greater LV mass and lower LV diastolic indices, similar to HIV- hypertensives, whose 24-h BP values were higher. Asymptomatic HIV infection and chronic HAART are associated with myocardial hypertrophy and preclinical diastolic dysfunction, independently of BP values.
authors.affiliation: Department of Clinical Medicine, University of Insubria, Ospedale di Circolo, Varese, Italy.
authors.forename: A M
authors.initials: AM
authors.lastname: Grandi
authors.forename: E
authors.initials: E
authors.lastname: Nicolini
authors.forename: M
authors.initials: M
authors.lastname: Giola
authors.forename: M
authors.initials: M
authors.lastname: Gianni
authors.forename: A M
authors.initials: AM
authors.lastname: Maresca
authors.forename: C
authors.initials: C
authors.lastname: Marchesi
authors.forename: L
authors.initials: L
authors.lastname: Guasti
authors.forename: M L
authors.initials: ML
authors.lastname: Balsamo
authors.forename: A
authors.initials: A
authors.lastname: Venco
authors.forename: P A
authors.initials: PA
authors.lastname: Grossi
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D016022:Case-Control Studies; D004452:Echocardiography; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D024821:Metabolic Syndrome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*; D016277:Ventricular Function, Left / Q000502:physiology*; D020257:Ventricular Remodeling