Autonomic and cardiovascular function in HIV spectrum disease: Early indications of cardiac pathophysiology

Abstract

Autonomic dysfunction in persons with acquired immune deficiency syndrome (AIDS) has been reported previously but its incidence in early stage HIV infection and its relation to cardiovascular function have not been fully examined. The present study evaluated cardiovascular and autonomic function in 55 HIV-seronegative, and 52 HIV-asymptomatic and 31 HIV-symptomatic seropositive men. Measures of hemodynamic and autonomic function were obtained at rest and during a standardized battery of autonomic tests. Results were compared across groups while controlling for age, body mass, and physical activity. Analyses indicated that measures of autonomic function did not differ among groups. However, at rest, both HIV seropositive groups exhibited diminished stroke volume and elevated diastolic blood pressure, albeit within normotensive levels. In addition, the ability to sustain a blood pressure response during prolonged challenge and the relationship between stroke volume and baroreceptor/vagal responsiveness were disrupted in the HIV-symptomatic group. Therefore, in the pre-AIDS stages of infection, autonomic functioning appeared intact; yet alterations in baroreceptor/vagal function associated with depressed myocardial function may be an early warning signal reflecting cardiovascular pathological processes potentially exacerbated by HIV spectrum disease.

Exercise training improves cardiovascular and autonomic profiles in HIV

“…Decreased sensitivity of the baroreflex causes a decrease in efferent vagal outflow to the heart, and a shift toward sympathetic activity. This reflexive decrease is highly correlated with CV disease, including myocardial infarction [4,22,32,33], hypertension [8], congestive heart failure [41,49], and sudden cardiac death [46].…”

Sympathoimmune Anomalies Underlying the Response to Stressful Challenge in Human Immunodeficiency Virus Spectrum Disease

“…Two hundred forty-seven individuals, who were part of a larger study of biobehavioral indices of disease progression in pre-AIDS HIV infection (14,15), were examined in this study. Venous sampling difficulties reduced the final study sample to 225, of which 92 subjects were HIVϪ and 133 subjects were HIVϩ.…”

“…Urine and blood samples were collected for toxicological screening and to derive complete blood count, HIV serostatus using both enzyme-linked immunoassay and Western blot methods, and immune parameters. Qualified subjects were then scheduled for the reactivity session and given presession substance and exercise restriction instructions (14).…”

Psychological Distress is Associated With Decreased Memory Helper T-cell and B-cell Counts in Pre-AIDS HIV Seropositive Men and Women but Only in Those With Low Viral Load

“…Participants were part of a larger study assessing acute mental stress-induced cardiovascular, autonomic, and immunocellular function in HIV spectrum disease (28).…”

“…Subjects also completed psychosocial questionnaires, a SCID interview, and a MiniMental Status exam. Within about 2 weeks, the mental stress testing session was held (for protocol details see 28). After an overnight stay in the General Clinical Research Center, subjects consumed a light breakfast (no caffeine) and were escorted to the Behavioral Medicine Research Center about 8 AM.…”