title: Cardiac dysfunction in pauci symptomatic human immunodeficiency virus patients: a meta-analysis in the highly active antiretroviral therapy era.
abstract: OBJECTIVE
  Human immunodeficiency virus infection (HIV) has been associated with cardiac dysfunction that, if present, can negatively affect morbidity and mortality of HIV-infected patients. Unfortunately, many of the studies on this topic were performed before the highly active antiretroviral therapy (HAART) was established. Thus, we performed a comprehensive meta-analysis to critically appraise the incidence of cardiac dysfunction in HIV-infected pauci symptomatic patients.
  
  
  RESULTS
  Medline, Cochrane Library, and Biomed Central were systematically screened for studies reporting on systolic and/or diastolic dysfunctions in HIV pauci-symptomatic patients. Baseline treatment and cardiac imaging data were appraised and pooled with random effect methods computing summary. At pooled analysis, including a total of 2242 patients from 11 studies, an overall average incidence of traditional cardiovascular risk factors was observed, while a low rate of previous coronary artery disease was reported. Incidence of systolic and diastolic left ventricular dysfunction was 8.33% (95% CI: 2.20-14.25) and 43.38% (95% CI: 31.73-55.03), respectively. Diastolic dysfunction was graded as first [31.85% (95% CI: 24.85-43.73)], second [8.53% (95% CI: 2.12-14.93)], and third degree [3.02% (95% CI: 1.78-4.27)]. At multivariate analysis, a high sensitivity C-reactive protein level >5 mg/L, active tobacco smoking and previous history of myocardial infarction were predictors of left ventricular systolic dysfunction [odd ratio 1.70 (95% CI: 1.03-2.77); 1.57 (95% CI: 1.03-2.34); and 15.90 (95% CI: 1.94-329.00), respectively]. Hypertension (OR = 2.30; 95% CI: 1.20-4.50) and older age (OR = 2.50 per 10 years increase; 95% CI: 1.70-3.60) were predictors of left ventricular diastolic dysfunction (Figure  3).
  
  
  CONCLUSIONS
  Systolic and diastolic dysfunction represent a common finding in pauci symptomatic HIV-infected patients, regardless to HAART.
authors: Division of Cardiology, Azienda Ospedaliera Cittá della Salute e della Scienza, Corso Bramante 88-90, 10126 Turin, Italy. enrico.cerrato@gmail.com
authors: Enrico
authors: E
authors: Cerrato
authors: Fabrizio
authors: F
authors: D'Ascenzo
authors: Giuseppe
authors: G
authors: Biondi-Zoccai
authors: Andrea
authors: A
authors: Calcagno
authors: Simone
authors: S
authors: Frea
authors: Walter
authors: W
authors: Grosso Marra
authors: Davide
authors: D
authors: Castagno
authors: Pierluigi
authors: P
authors: Omedè
authors: Giorgio
authors: G
authors: Quadri
authors: Filippo
authors: F
authors: Sciuto
authors: Davide
authors: D
authors: Presutti
authors: Giacomo
authors: G
authors: Frati
authors: Stefano
authors: S
authors: Bonora
authors: Claudio
authors: C
authors: Moretti
authors: Fiorenzo
authors: F
authors: Gaita
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015658:HIV Infections / Q000188:drug therapy* / Q000503:physiopathology; D006331:Heart Diseases / Q000503:physiopathology / Q000821:virology*; D006801:Humans; D008875:Middle Aged; D013318:Stroke Volume / Q000502:physiology; D015899:Tomography, Emission-Computed, Single-Photon
keywords: Antiretroviral therapy; Echocardiography; HAART; HIV; Heart failure