title: Impact of HIV infection on cardiac deformation.
abstract: OBJECTIVE
  The aim of this study was to detect abnormalities in left ventricular myocardial function due to HIV (human immunodeficiency virus) infection without established cardiovascular disease.
  
  
  METHODS
  An echocardiogram was performed in 50 asymptomatic HIV-infected patients (age 41 ± 6 years, 64% male) and in 20 healthy individuals. Conventional echocardiography and pulsed tissue Doppler imaging (TDI) were performed according to the guidelines. The strain rate of the basal segments was obtained with color tissue Doppler and used to evaluate systolic strain rate (SRS), early diastolic strain rate (SRE) and late diastolic strain rate (SRA). Longitudinal, radial and circumferential strain were assessed by 2D speckle tracking.
  
  
  RESULTS
  The mean duration of HIV infection was 10 ± 5 years, CD4 count was 579 ± 286 cells/mm³, 32% had detectable viral load, and 86% were under treatment. Of the HIV-infected patients, one had grade 1 diastolic dysfunction. The groups were not different except for E wave (HIV 0.72 ± 0.17 m/s vs. control 0.84 ± 0.16 m/s, p=0.01), longitudinal strain (-19.5 ± 1.9% vs. -21 ± 2%, p=0.005), SRS (-1.1 ± 0.28 s⁻¹ vs. -1.3 ± 0.28 s⁻¹, p=0.02) and SRE (1.8 ± 0.4 s⁻¹ vs. 2.2 ± 0.4 s⁻¹, p<0.001), but only SRS (p=0.03, 95% CI 0.036; 0.67) and SRE (p=0.001, 95% CI -0.599; -0.168) had independent value.
  
  
  CONCLUSIONS
  In an HIV-infected population without established cardiovascular disease, myocardial deformation abnormalities can be detected with strain and strain rate, revealing markers of myocardial injury.
authors.affiliation: Cardiology Department, Hospital de São Bernardo, Setúbal, Portugal. Electronic address: ligiamendes76@gmail.com.
authors.forename: Lígia
authors.initials: L
authors.lastname: Mendes
authors.affiliation: Cardiology Department, Hospital Militar, Lisboa, Portugal.
authors.forename: Daniela
authors.initials: D
authors.lastname: Silva
authors.affiliation: Cardiology Department, Hospital de São Bernardo, Setúbal, Portugal.
authors.forename: Carla
authors.initials: C
authors.lastname: Miranda
authors.affiliation: Infectious Disease Department, Hospital de São Bernardo, Setúbal, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Sá
authors.affiliation: Infectious Disease Department, Hospital de São Bernardo, Setúbal, Portugal.
authors.forename: Luís
authors.initials: L
authors.lastname: Duque
authors.affiliation: Infectious Disease Department, Hospital de São Bernardo, Setúbal, Portugal.
authors.forename: Nelson
authors.initials: N
authors.lastname: Duarte
authors.affiliation: Infectious Disease Department, Hospital de São Bernardo, Setúbal, Portugal.
authors.forename: Paula
authors.initials: P
authors.lastname: Brito
authors.affiliation: Cardiology Department, Hospital de São Bernardo, Setúbal, Portugal.
authors.forename: Leonel
authors.initials: L
authors.lastname: Bernardino
authors.affiliation: Infectious Disease Department, Hospital de São Bernardo, Setúbal, Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Poças
mesh_terms: D000328:Adult; D058345:Asymptomatic Infections; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D015150:Echocardiography, Doppler; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000821:virology; D016277:Ventricular Function, Left; D019562:Viral Load
keywords: Color tissue Doppler; Deformação miocárdica; Doppler tecidular; HIV infection; Infeção VIH; Mecanismos miocárdicos; Myocardial mechanics; Myocardium deformation; Speckel tracking; Speckle tracking