TY - JOUR
TI - Myocardial deformation imaging unmasks subtle left ventricular systolic dysfunction in asymptomatic and treatment-naïve HIV patients
AU - Karavidas, A.
AU - Xylomenos, G.
AU - Matzaraki, V.
AU - Papoutsidakis, N.
AU - Leventopoulos, G.
AU - Farmakis, D.
AU - Lazaros, G.
AU - Perpinia, A.
AU - Arapi, S.
AU - Paisios, N.
AU - Parissis, J.
AU - Pyrgakis, V.
AU - Gargalianos, P.
JO - Clinical Research in Cardiology
PY - 2015
VL - 104
TODO - 11
SP - 975-981
PB - Dr. Dietrich Steinkopff Verlag GmbH and Co. KG
SN - 1861-0684, 1861-0692
TODO - 10.1007/s00392-015-0866-8
TODO - adult;  Article;  cardiomyopathy;  clinical article;  controlled study;  Doppler echography;  echocardiography;  enzyme linked immunosorbent assay;  female;  heart function;  human;  Human immunodeficiency virus infection;  left ventricular systolic dysfunction;  male;  middle aged;  risk factor;  virus load;  Western blotting;  complication;  computer assisted diagnosis;  differential diagnosis;  echography;  elastography;  etiology;  heart left ventricle function;  Human immunodeficiency virus infection;  pathophysiology;  procedures;  reproducibility;  sensitivity and specificity;  Young modulus, Adult;  Diagnosis, Differential;  Elastic Modulus;  Elasticity Imaging Techniques;  Female;  HIV Infections;  Humans;  Image Interpretation, Computer-Assisted;  Male;  Reproducibility of Results;  Sensitivity and Specificity;  Ventricular Dysfunction, Left
TODO - Background: Patients infected by the human immunodeficiency virus (HIV) and receiving highly active antiretroviral therapy have a higher incidence of cardiovascular disease than healthy subjects, but little is known about cardiac function in asymptomatic and treatment-naïve patients. We sought to study cardiac function in asymptomatic HIV-infected, treatment-naïve patients. Methods: We studied 41 HIV-infected and treatment-naïve patients and 20 age- and sex-matched healthy controls. Patients with cardiac symptoms, history of cardiac disease or NT-proBNP >100 pg/mL were excluded. We addressed cardiac function using standard echocardiography along with tissue Doppler (TDI) measurements, including strain/strain rate assessment. Results: Standard echocardiographic parameters did not differ between groups, except for transmitral E wave velocity (64.8 ± 14 cm/s in HIV vs 76.1 ± 10 cm/s in controls, p = 0.002). In contrast, TDI mitral and tricuspid annulus s velocity and all strain/strain rate measurements were significantly lower in HIV patients: s lateral, 10.2 ± 2.4/11.3 ± 0.7, p = 0.011; s septal, 8.1 ± 1.6/8.7 ± 0.8, p = 0.045; s tricuspid, 13.4 ± 2.3/14.9 ± 1.3, p = 0.002; strain/strain rate, septal (strain/strain rate, 15.1 ± 5.7/−0.9 ± 0.3, 25.3 ± 1.7/−1.9 ± 0.2, p < 0.001), anterior (16.7 ± 3/−1.0 ± 0.1, 26.7 ± 1.7/−1.9 ± 0.2, p < 0.001), lateral (16.0 ± 6/−1.0 ± 0.1, 27.5 ± 1.8/−2.2 ± 0.3, p < 0.001) and posterior (15.2 ± 5.8/−1.0 ± 0.2, 26.2 ± 1.8/−2.2 ± 0.3, p < 0.001) left ventricular wall. Conclusions: HIV infection itself is accompanied by subclinical systolic dysfunction, not apparent to standard echocardiography that can be unmasked though using sensitive echocardiographic techniques. © 2015, Springer-Verlag Berlin Heidelberg.
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