title: HIV is an independent predictor of aortic stiffness.
abstract: BACKGROUND
  Patients with treated Human Immunodeficiency Virus-1 (HIV) infection are at increased risk of cardiovascular events. Traditionally much of this risk has been attributed to metabolic and anthropometric abnormalities associated with HIV, which are similar to the metabolic syndrome (MS), an established risk factor for cardiovascular mortality. It remains unclear whether treated HIV infection is itself associated with increased risk, via increase vascular stiffness.
  
  
  METHODS
  226 subjects (90 with HIV) were divided into 4 groups based on HIV and MS status: 1) HIV-ve/MS-ve, 2) HIV-ve/MS + ve, 3) HIV + ve/MS-ve and 4)HIV + ve/MS + ve. CMR was used to determine aortic pulse wave velocity (PWV) and regional aortic distensibility (AD).
  
  
  RESULTS
  PWV was 11% higher and regional AD up to 14% lower in the HIV + ve/MS-ve group when compared to HIV-ve/MS-ve (p < 0.01 all analyses). PWV and AD in the HIV + ve/MS-ve group was similar to that observed in the HIV-ve/MS + ve group (p > 0.99 all analyses). The HIV + ve/MS + ve group had 32% higher PWV and 30-34% lower AD than the HIV-ve/MS-ve group (all p < 0.001), and 19% higher PWV and up to 31% lower AD than HIV + ve/MS-ve subjects (all p < 0.05). On multivariable regression, age, systolic blood pressure and treated HIV infection were all independent predictors of both PWV and regional AD.
  
  
  CONCLUSIONS
  Across multiple measures, treated HIV infection is associated with increased aortic stiffness and is also an independent predictor of both PWV and regional AD. The magnitude of the effect of treated HIV and MS are similar, with additive detrimental effects on central vascular elasticity.
authors.affiliation: Department of Physiology, Anatomy and Genetics, University of Oxford, Parks Road, Oxford, OX1 3PT, UK. oliver.rider@gmail.com.|Department of Cardiovascular Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research, (OCMR), John Radcliffe Hospital, Oxford, OX3 9DU, UK. oliver.rider@gmail.com.
authors.forename: Oliver J
authors.initials: OJ
authors.lastname: Rider
authors.affiliation: Department of Physiology, Anatomy and Genetics, University of Oxford, Parks Road, Oxford, OX1 3PT, UK. mina-asaad@hotmail.com.|Department of Cardiovascular Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research, (OCMR), John Radcliffe Hospital, Oxford, OX3 9DU, UK. mina-asaad@hotmail.com.
authors.forename: Mina
authors.initials: M
authors.lastname: Asaad
authors.affiliation: Department of Cardiovascular Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research, (OCMR), John Radcliffe Hospital, Oxford, OX3 9DU, UK. ntobeko.ntusi@cardiov.ox.ac.uk.
authors.forename: Ntobeko
authors.initials: N
authors.lastname: Ntusi
authors.affiliation: Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK. emmawainwright@hiv-gum.org.
authors.forename: Emma
authors.initials: E
authors.lastname: Wainwright
authors.affiliation: Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK. genevieve.clutton@merton.ox.ac.uk.
authors.forename: Genevieve
authors.initials: G
authors.lastname: Clutton
authors.affiliation: Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK. gemma.hancock@ndm.ox.ac.uk.
authors.forename: Gemma
authors.initials: G
authors.lastname: Hancock
authors.affiliation: Department of Physiology, Anatomy and Genetics, University of Oxford, Parks Road, Oxford, OX1 3PT, UK. rajarshi.banerjee@cardiov.ox.ac.uk.
authors.forename: Rajarshi
authors.initials: R
authors.lastname: Banerjee
authors.affiliation: Department of Cardiovascular Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research, (OCMR), John Radcliffe Hospital, Oxford, OX3 9DU, UK. alex.pitcher@cardiov.ox.ac.uk.
authors.forename: Alex
authors.initials: A
authors.lastname: Pitcher
authors.affiliation: St Vincent's Hospital, Sydney, Australia. k.samaras@garvan.org.au.
authors.forename: Katherine
authors.initials: K
authors.lastname: Samaras
authors.affiliation: Department of Physiology, Anatomy and Genetics, University of Oxford, Parks Road, Oxford, OX1 3PT, UK. kieran.clarke@dpag.ox.ac.uk.
authors.forename: Kieran
authors.initials: K
authors.lastname: Clarke
authors.affiliation: Department of Cardiovascular Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research, (OCMR), John Radcliffe Hospital, Oxford, OX3 9DU, UK. stefan.neubauer@cardiov.ox.ac.uk.|Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK. stefan.neubauer@cardiov.ox.ac.uk.
authors.forename: Stefan
authors.initials: S
authors.lastname: Neubauer
authors.affiliation: Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK. lucy.dorrell@imm.ox.ac.uk.
authors.forename: Lucy
authors.initials: L
authors.lastname: Dorrell
authors.affiliation: Department of Physiology, Anatomy and Genetics, University of Oxford, Parks Road, Oxford, OX1 3PT, UK. cholloway@stvincents.com.au.|Department of Cardiovascular Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research, (OCMR), John Radcliffe Hospital, Oxford, OX3 9DU, UK. cholloway@stvincents.com.au.|St Vincent's Hospital, Sydney, Australia. cholloway@stvincents.com.au.
authors.forename: Cameron J
authors.initials: CJ
authors.lastname: Holloway
mesh_terms: D000328:Adult; D000367:Age Factors; D023241:Antiretroviral Therapy, Highly Active; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000503:physiopathology* / Q000821:virology; D016022:Case-Control Studies; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology; D015497:HIV-1 / Q000472:pathogenicity; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000628:therapy / Q000821:virology; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis; D012307:Risk Factors; D059289:Vascular Stiffness