title: Evaluation of human immunodeficiency virus infection-related left ventricular systolic dysfunction by tissue Doppler strain echocardiography.
abstract: OBJECTIVE
  Cardiovascular involvement causes significant morbidity and mortality among patients with human immunodeficiency virus (HIV) infection. Since the introduction of highly active antiretroviral treatment (HAART), subtle changes in left ventricular (LV) function, which may be clinically silent, have become more pronounced in HIV patients. Echocardiographic strain imaging (SI) may detect subclinical myocardial dysfunction at an earlier stage compared with conventional echocardiography. The aim of this study was to evaluate tissue Doppler-derived LV strain and strain rate (SR) along with conventional measures of LV function in asymptomatic, stable adult HIV patients on HAART.
  
  
  METHODS
  Twenty-one patients with HIV infection (mean age: 37.8 ± 11.9 years, 11 males) who had no cardiovascular complaints and 27 healthy volunteers (mean age: 40.9 ± 5.8 years, 14 males) were enrolled. Traditional parameters including LV ejection fraction (EF) were measured along with tissue velocity imaging (TVI) and tissue Doppler SI parameters using transthoracic echocardiography.
  
  
  RESULTS
  The mean duration of HIV infection was 30.8 ± 25.1 (3-120) months. The mean LVEF in HIV group was within normal limits but lower than controls (64.5% ± 10.2% vs. 72.2% ± 6.4%, P = 0.003). There were no differences in other major traditional measures, as well as TVI parameters between groups. LV systolic strain and SR parameters were impaired indicating subtle LV systolic dysfunction in HIV group. No difference in diastolic function was observed between groups.
  
  
  CONCLUSIONS
  Left ventricular systolic strain parameters may be utilized to demonstrate subtle LV systolic dysfunction in asymptomatic HIV patients.
authors.affiliation: Department of Cardiology, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Imran
authors.initials: I
authors.lastname: Onur
authors.forename: Baris
authors.initials: B
authors.lastname: Ikitimur
authors.forename: Fahrettin
authors.initials: F
authors.lastname: Oz
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ekmekci
authors.forename: Ali
authors.initials: A
authors.lastname: Elitok
authors.forename: Arif Atahan
authors.initials: AA
authors.lastname: Cagatay
authors.forename: Kamil
authors.initials: K
authors.lastname: Adalet
authors.forename: Ahmet Kaya
authors.initials: AK
authors.lastname: Bilge
authors.forename: Mehmet Gungor
authors.initials: MG
authors.lastname: Kaya
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D018619:Echocardiography, Doppler, Pulsed / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013318:Stroke Volume / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000821:virology*
keywords: echocardiography; human immunodeficiency virus infection; left ventricular dysfunction; strain; strain rate