title: Valvular manifestations of human immunodeficiency virus infection--results from the prospective, multicenter HIV-HEART study.
abstract: OBJECTIVE
  HIV infection is associated with an elevated rate of cardiac diseases. The aim of the current study was to assess the prevalence of valvular disorders in a large population of HIV-infected patients.
  
  
  METHODS
  We enrolled 803 adults (age 44 ± 10 years, 16.6% women) in this prospective, multicenter cohort study. All patients underwent a comprehensive two-dimensional transthoracic echocardiography examination including Doppler evaluation of valvular function. Statistical analyses were performed in respect of severity of HIV infection.
  
  
  RESULTS
  Overall, the rate of patients with pathologic function of cardiac valves was 77.6% (N = 623). Most of these patients had signs of valvular regurgitation (N = 620; 77.2%), whereas stenoses were rare (N = 23; 2.9%). Clinically relevant valvular disorders (excluding mild stages) were seen in only 4.7% (N = 38; regurgitation: N = 36, 4.5%; stenosis: N = 3, 0.4%). Clinical stages of HIV infection, defined by the Centers for Disease Control and Prevention (CDC) classification, were associated with higher rates of valvular diseases (CDC-stage B/C versus A: 6.2 versus 2.3%, P = 0.015). However, there was no association between current CD4 cell count or virus load and the prevalence of valvular disorders (both P > 0.2). None of the patients had signs of active endocarditis in the present study.
  
  
  CONCLUSIONS
  Valvular heart diseases are common in HIV-infected patients. Fortunately, most of these disorders are mild today. We found an association between the onset of valvular heart disease and clinical stages of HIV infection.
authors: aDepartment of Cardiology, West-German Heart Center bDepartment of Dermatology and Venereology, University of Essen, Essen cCenter for Clinical Trials (ZKS), University of Leipzig, Leipzig dDepartment of Dermatology, Ruhr-University Bochum, Bochum, Germany.
authors: Nico
authors: N
authors: Reinsch
authors: Stefan
authors: S
authors: Esser
authors: Götz
authors: G
authors: Gelbrich
authors: Norbert
authors: N
authors: Brockmeyer
authors: Anja
authors: A
authors: Potthoff
authors: Dirk
authors: D
authors: Schadendorf
authors: Raimund
authors: R
authors: Erbel
authors: Till
authors: T
authors: Neumann
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D015150:Echocardiography, Doppler; D005260:Female; D005858:Germany / Q000453:epidemiology; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology; D006351:Heart Valves / Q000000981:diagnostic imaging / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index