title: Longitudinal assessment of cardiac diastolic function in HIV-infected patients.
abstract: Asymptomatic isolated diastolic dysfunction (DD), with normal left ventricular systolic function, may be the first indication of underlying cardiac disease in HIV-negative populations. We previously reported a high prevalence (37%) of DD among asymptomatic HIV-infected patients at low risk for AIDS and cardiovascular disease (CVD). We performed a longitudinal assessment of interval echocardiographic changes in this cohort over a four-year period. Repeat transthoracic echocardiograms (TTEs) utilized standard techniques. Sixty (of the original 91) HIV-infected patients, predominately men, underwent repeat TTE (median follow-up 3.7 years, interquartile range [IQR] 3.5, 4.0). Cohort characteristics (median; IQR) include age 42.0 (36.5, 46.0) years, HIV duration 16.4 years (8.1, 18.9), current CD4 count 572.0 cells/mm(3) (436.5, 839.0), antiretroviral therapy (ART) duration 8.1 years (4.8, 13.4) and Framingham risk score 1.0 (0.0, 2.0). DD was observed in 28/60 patients on re-evaluation (47%, 95% confidence interval [CI] 34%, 60%); 31% (11/36) of patients had new onset DD for an overall incidence of 8.2/100 person-years. On follow-up, subjects with DD were older, had a trend towards higher body mass index, hypertension and longer duration of HIV infection compared with subjects without DD. We confirmed a high prevalence of DD (47%) in asymptomatic HIV-infected patients at low risk for AIDS and CVD.
authors.affiliation: Walter Reed Army Medical Center, Washington, DC, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Blaylock
authors.forename: D K
authors.initials: DK
authors.lastname: Byers
authors.forename: B T
authors.initials: BT
authors.lastname: Gibbs
authors.forename: G
authors.initials: G
authors.lastname: Nayak
authors.forename: M
authors.initials: M
authors.lastname: Ferguson
authors.forename: D R
authors.initials: DR
authors.lastname: Tribble
authors.forename: C
authors.initials: C
authors.lastname: Porter
authors.forename: C F
authors.initials: CF
authors.lastname: Decker
mesh_terms: D000328:Adult; D003971:Diastole; D004452:Echocardiography; D005260:Female; D015658:HIV Infections / Q000503:physiopathology*; D006331:Heart Diseases / Q000503:physiopathology* / Q000821:virology*; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D013599:Systole