title: Relationships among HIV infection, metabolic risk factors, and left ventricular structure and function.
abstract: Our objective was to determine if the presence of metabolic complications (MC) conveyed an additional risk for left ventricular (LV) dysfunction in people with HIV. HIV⁺ and HIV⁻ men and women were categorized into four groups: (1) HIV⁺ with MC (43±7 years, n=64), (2) HIV⁺ without MC (42±7 years, n=59), (3) HIV⁻ with MC (44±8 years, n=37), or (4) HIV⁻ controls without MC (42±8 years, n=41). All participants underwent two-dimensional (2-D), Doppler, and tissue Doppler echocardiography. Overall, the prevalence of systolic dysfunction (15 vs. 4%, p=0.02) and LV hypertrophy (9 vs. 1%, p=0.03) was greater in HIV⁺ than in HIV⁻ participants. Participants with MC had a greater prevalence of LV hypertrophy (10% vs. 1%). Early mitral annular velocity during diastole was significantly (p<0.005) lower in groups with MC (HIV⁺/MC⁺: 11.6±2.3, HIV⁻/MC⁺: 12.0±2.3 vs. HIV⁺/MC⁻: 12.4±2.3, HIV⁻/MC⁻: 13.1±2.4 cm/s) and tended to be lower in groups with HIV (p=0.10). However, there was no interaction effect of HIV and MC for any systolic or diastolic variable. Regardless of HIV status, participants with MC had reduced LV diastolic function. Although both the presence of MC and HIV infection were associated with lower diastolic function, there was no additive negative effect of HIV on diastolic function beyond the effect of MC. Also, HIV was independently associated with lower systolic function. Clinical monitoring of LV function in individuals with metabolic risk factors, regardless of HIV status, is warranted.
authors.affiliation: Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO 63108, USA. tcade@wustl.edu
authors.forename: William Todd
authors.initials: WT
authors.lastname: Cade
authors.forename: Edgar Turner
authors.initials: ET
authors.lastname: Overton
authors.forename: Kristin
authors.initials: K
authors.lastname: Mondy
authors.forename: Lisa
authors.initials: L
authors.lastname: de las Fuentes
authors.forename: Victor G
authors.initials: VG
authors.lastname: Davila-Roman
authors.forename: Alan D
authors.initials: AD
authors.lastname: Waggoner
authors.forename: Dominic N
authors.initials: DN
authors.lastname: Reeds
authors.forename: Sherry
authors.initials: S
authors.lastname: Lassa-Claxton
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Krauss
authors.forename: Linda R
authors.initials: LR
authors.lastname: Peterson
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Yarasheski
mesh_terms: D000328:Adult; D015150:Echocardiography, Doppler; D005260:Female; D015658:HIV Infections / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D016277:Ventricular Function, Left / Q000502:physiology*