Cardiac Dysfunction Among People Living With HIV

Erqou, Sebhat; Lodebo, Bereket Tessema; Masri, Ahmad; Altibi, Ahmed; Echouffo‐Tcheugui, Justin B.; Dzudie, Anastase; Ataklte, Feven; Choudhary, Gaurav; Bloomfield, Gerald S.; Wu, Wen Chih; Kengne, André Pascal

doi:10.1016/j.jchf.2018.10.006

Cited by 75 publications

(55 citation statements)

References 26 publications

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“…Prior studies from sub-Saharan Africa have described a higher prevalence of reduced LVEF. Our findings are consistent with more contemporary ART-treated PLHIV in high-income countries 24. The worse LV GLS and increased LV mass among PLHIV may presage overt clinical myocardial dysfunction (ie, HF); however, this hypothesis requires further investigation.…”

Section: Discussionsupporting

confidence: 84%

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HIV and pericardial fat are associated with abnormal cardiac structure and function among Ugandans

Buggey¹,

Yun

Hung

et al. 2019

Heart

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ObjectivesTo examine the relationship between pericardial fat (PCF) and cardiac structure and function among HIV-infected patients in the sub-Saharan African country of Uganda. People living with HIV (PLHIV) have altered fat distribution and an elevated risk for heart failure. Whether altered quantity and radiodensity of fat surrounding the heart relates to cardiac dysfunction in this population is unknown.MethodsOne hundred HIV-positive Ugandans on antiretroviral therapy were compared with 100 age and sex-matched HIV-negative Ugandans; all were >45 years old with >1 cardiovascular disease risk factor. Subjects underwent ECG-gated non-contrast cardiac CT and transthoracic echocardiography with speckle tracking strain imaging. Multivariable linear and logistic regression models were used to explore the association of PCF with echocardiographic outcomes.ResultsMedian age was 55% and 62% were female. Compared with uninfected controls, PLHIV had lower body mass index (27 vs 30, p=0.02) and less diabetes (26% vs 45%, p=0.005). Median left ventricular (LV) ejection fraction was 67%. In models adjusted for traditional risk factors, HIV was associated with 10.3 g/m2 higher LV mass index (LVMI) (95% CI 3.22 to 17.4; p=0.005), 0.87% worse LV global longitudinal strain (GLS) (95% CI −1.66 to −0.07; p=0.03) and higher odds of diastolic dysfunction (OR 1.96; 95% CI 0.95 to 4.06; p=0.07). In adjusted models, PCF volume was significantly associated with increased LVMI and worse LV GLS, while PCF radiodensity was associated with worse LV GLS (all p<0.05).ConclusionsIn Uganda, HIV infection, PCF volume and density are associated with abnormal cardiac structure and function.

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Section: Discussionsupporting

confidence: 84%

“…Prior studies have identified HIV as a risk factor for subclinical alterations in cardiac structure and function3 24 and higher risk of clinical HF 8–10. Studies of cardiac dysfunction in sub-Saharan Africa have included higher proportions of persons with more advanced immunosuppression.…”

Section: Discussionmentioning

confidence: 99%

HIV and pericardial fat are associated with abnormal cardiac structure and function among Ugandans

Buggey¹,

Yun

Hung

et al. 2019

Heart

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“…Though the prevalence was low in our study, a similarity in age group was found (mean age of our study was 38.8 year)A high percentage of young patients in our study group may be responsible for the similar findings. Erquo et al (28) have reported that the pooled prevalence of grade Ito grade III diastolic dysfunction is 29.3% and grade II to III diastolic dysfunction is 11.7%.In this study we didn't find any statistical correlation between diastolic dysfunction and CD4 count , WHO staging . but out of 30 pts (who were WHO stage 3&4) 16 having diastolic dysfunction.…”

Section: Inclusion Criteria-contrasting

confidence: 62%

Cardiovascular Manifestations in Hiv Positive Patients in a Tertiary Care Hospital, Central India

Shukla

Malhotra

Lakra

2021

IJMBS

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Background: Acquired immune deficiency syndrome (AIDS) is one of the major public health problem in india .HIV estimates report (2019)(1) of the Government, India is estimated to have around 23.49 lakh people living with HIV/AIDS (PLHIV) in 2019 . in Chhattisgarh it is 42520&HIV incidence per 1,000 uninfected population is 0.1 .with the recent advancements in therapy early mortality in HIV cases are significantly reduced but cardiovascular abnormalities are frequently seen as the disease progress and is associated with decreased quality of life. Aims and objective: To know the pattern and prevalence of various cardiovascular manifestations in HIV positive patients and its association with CD4 count, WHO stage of disease and ART Material and Methods: for the period of 1.3 years from JANUARY 2019 TO APRIL 2020studyis conducted in the Department of Medicine, PT.JNM Medical College and Dr. BRAMH, Raipur. A total of 137 HIV positive patients of age>18 years, all are on ART are included.patients included in the study underwent detailed history taking, clinical examination and investigations. Details of the history, clinical examination and investigations were noted in the proforma. The cardiovascular examination in the form of chest x-ray, ECG, 2D echocardiography and NT-ProBNP was done and their correlationswith CD4 count and WHO disease stage is studied accordingly. Electrocardiogram, chest x-ray and 2D echocardiography was done immediately following blood investigation. Result: Majority (45.25%) of the patients involved in this study were in age group of 31-45 year with the overall average mean age of 38.86 years. Male to female ratio was 3.1:1. On x-ray cardiomegaly found in 25.5% pts baseline ECG abnormalitities seen in 47.4% pts . echocardiographic abnormality seen in 56.2% pts .The commonest finding in our study is valvular abnormalities in 55 pts (40.1%) followed by diastolic dysfunction in 45 pts(32.8%). Other less common cardiac manifestations in decreasing order of frequency were reduced LVEF in 33 pts(24%), pericardial effusion in 15 pts (10.9%),left ventricular hypertrophy in 13 pts (9.4%), pulmonary arterial hypertension in 10 pts (7.2%)and regional wall motion abnormality in 9 pts (6.5%). We found A strong statistical correlation found between CD4 count and pericardial effusion in 2D-ECHO (p= 0.0410023). Also strong statistical correlation (p=0.016456) is found between the WHO stage of disease and cardiomegaly, strong statistical correlation found between WHO staging of disease and QRS abnormalities (p= 0.02551) and inverted T wave (p= 0.000528), strong statistical correlation found between WHO stage of disease and pulmonary arterial hypertension in 2D-ECHO (p=0.006832). And statistical association found between WHO stage of disease and regional wall motion abnormality (RWMA) in 2D-ECHO (p=0.002541). Conclusion: The results of the study indicate that cardiovascular abnormalities in HIV infected patients are common. Cardiac involvement and cardiovascular complications are commonly seen in HIV-infected patients and can present without any clinical manifestation. The common cardiovascular manifestation seen in our study patients is valvular leaks, regional wall motion abnormality, pericardial effusion, reduced EF etc. The incidence of cardiovascular manifestations increases as the disease progresses and CD4 count decreases. Keywords: Prevalence, Cardiovascular, Abnormalities & HIV. Study Designed: Cross Sectional Observational Study.

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“…However, while the treadmill speed and inclination for the RTT were equivalent between the two groups, both parameters were lower than what is typically standard for the test and, therefore, presented with equal reductions. As such, it should be noted that even with stable ART regimens and adequate CD4 cell counts, the prevalence and incidence rates of cardiovascular [35], gait [36], and balance [37] dysfunctions are excessive in those infected with HIV. Although we emphasize the benefits of participating in a community-based exercise program, we are also mindful of the prospect that the resemblances identified between the groups could be attributed to other elements that may potentially have affected the subjects' cardio-motor profiles; among which are common comorbidities often seen in PLHIV, such as peripheral neuropathy and chronic pain.…”

Section: Discussionmentioning

confidence: 99%

Latinxs with HIV: Depressive Cognitive Alterations as a Precursor to Cardio-Motor Deficits

Hyder

Rosario

2021

Int. J. Phys. Educ. Fit. Sports

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HIV is a debilitating infection that often presents with health-related complications, further reducing quality of life. Of the most common comorbidities accompanying HIV is depression, which can induce cognitive alterations alongside those resulting from the virus. Latinxs are disproportionately susceptible to both afflictions and face innumerable challenges in the identification and diagnosis of depression. Consequently, HIV-infected Latinxs may experience additional cognitive symptomatology from the simultaneous prevalence of depression and HIV, potentially affecting their gait and cardiovascular profiles. This study aimed to determine the impact of depression on cardio-motor components in HIV-infected Latinxs. Records of 291 stable HIV+ participants were collected from La Perla de Gran Precio Community Center, analyzed for depression, and respectively allocated to the depression group (70) and the group without depression (221). Cardio-motor values were obtained by conducting the Ross treadmill test, a submaximal cardiovascular assessment. An ANOVA revealed similarities in cardiomotor profiles between groups, alluding to the absence of depression-induced modifications to gait and cardiovascular health. Community exercise and cardiopulmonary intervention programs are beneficial to the quality of life in this population during all stages of HIV. However, HIV-infected Latinxs with depression face acute cultural challenges, causing diagnoses and treatment oversights and deficiencies for those who are suffering. Public health efforts should aim to remove barriers facing this population to ultimately reduce the inflated prevalence of both afflictions. Future research should focus on the crucial differentiation of Latinx depressive symptoms from those identical in HIV prior to reinvestigating cardiomotor alterations.

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Cardiac Dysfunction Among People Living With HIV

Cited by 75 publications

References 26 publications

HIV and pericardial fat are associated with abnormal cardiac structure and function among Ugandans

HIV and pericardial fat are associated with abnormal cardiac structure and function among Ugandans

Cardiovascular Manifestations in Hiv Positive Patients in a Tertiary Care Hospital, Central India

Latinxs with HIV: Depressive Cognitive Alterations as a Precursor to Cardio-Motor Deficits

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