title: Contributions of pulmonary hypertension to HIV-related cardiac dysfunction.
abstract: OBJECTIVE
  To evaluate the prevalence of pulmonary hypertension among patients living with HIV/AIDS and to determine its contribution to cardiac dysfunction.
  
  
  METHODS
  A hospital based cross sectional study was carried out over a 6-month period at the Jos University Teaching Hospital. The subjects were 200 confirmed HIV positive patients, ≥18 years of age who consented to the study. Physical examination, laboratory investigations, 2 dimensional and Doppler echocardiography were conducted on the subjects.
  
  
  RESULTS
  The mean age of the patients was 38 ± 9 years, and there were 142 females (71%). Females were younger, mean age 36 ± 8 years versus 41 ± 10 years for males (p-value <0.01). The median CD4 cell count was 312 cells/μl, there were no homosexual or intravenous drug user among the subjects. Eight of the subjects had pulmonary hypertension, with a case prevalence of 4%, and this had no relationship to CD4 cell count. Both systolic and diastolic functions were worse in subjects with pulmonary hypertension, with a negative correlation between mean pulmonary arterial systolic pressure (mPASP) and parameters like ejection fraction (r = -0.28, p-value 0.0003), fractional shortening (r = -0.21, p-value 0.003), deceleration time (r = -0.13. p-value 0.09).
  
  
  CONCLUSIONS
  Immune-suppression affects the cardiac function adversely and coexisting pulmonary hypertension contributes to poor systolic and diastolic function in affected patients. The subtle nature of presentation of pulmonary hypertension and other cardiac dysfunctions in HIV/AIDS patients demand a high-index of suspicion and early intervention if detected, to ensure better care for these emerging threats to our patients.
authors.affiliation: Internal Medicine Department, Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria. Electronic address: isiguzogodsent@yahoo.com.
authors.forename: Godsent C
authors.initials: GC
authors.lastname: Isiguzo
authors.forename: Basil N
authors.initials: BN
authors.lastname: Okeahialam
authors.forename: Solomon S
authors.initials: SS
authors.lastname: Danbauchi
authors.forename: Augustine N
authors.initials: AN
authors.lastname: Odili
authors.forename: Michael O
authors.initials: MO
authors.lastname: Iroezindu
authors.forename: Ugoagwu
authors.initials: U
authors.lastname: Placid
mesh_terms: D000328:Adult; D017677:Age Distribution; D015897:Comorbidity; D003430:Cross-Sectional Studies; D018450:Disease Progression; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D054144:Heart Failure, Diastolic / Q000175:diagnosis / Q000453:epidemiology; D054143:Heart Failure, Systolic / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D013318:Stroke Volume / Q000502:physiology*; D016019:Survival Analysis; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D055815:Young Adult
keywords: Cardiac dysfunction; HIV; Pulmonary hypertension