Clinical Application of Cardiac Magnetic Resonance in ART-Treated AIDS Males with Short Disease Duration

Abstract

Cardiac complications are common in antiretroviral therapy-treated (ART-treated) acquired immune deficiency syndrome (AIDS) patients, and the incidence increases with age. Myocardial injury in ART-treated AIDS patients with a relatively longer disease duration has been evaluated. However, there is no relevant study on whether patients with a short AIDS duration have cardiac dysfunction. Thirty-seven ART-treated males with AIDS and eighteen healthy controls (HCs) were prospectively included for CMR scanning. Clinical data and laboratory examination results were collected. The ART-treated males with AIDS did not have significantly reduced biventricular ejection fraction, myocardial edema, or late gadolinium enhancement. Compared with the HCs, the biventricular volume parameters and left ventricle myocardial strain indices in ART-treated males with AIDS were not significantly reduced (all p > 0.05). ART-treated males with AIDS were divided into subgroups according to their CD4+ T-cell counts (<350 cells/μL and ≥350 cells/μL) and duration of disease (1–12 months, 13–24 months, and 25–36 months). There was no significant decrease in left or right ventricular volume parameters or myocardial strain indices among the subgroups (all p > 0.05). In Pearson correlation analysis, CD4+ T-cell counts were not significantly correlated with biventricular volume parameters or left ventricular myocardial strain indices. In conclusion, ART-treated males with AIDS receiving ART therapy with a short disease duration (less than 3 years) might not develop obvious cardiac dysfunction as evaluated by routine CMR, so it is reasonable to appropriately extend the interval between cardiovascular follow-ups to more than 3 years.

The Multi-Faceted Utility of Cardiovascular Magnetic Resonance Imaging: Editorial on Special Issue “Advances in Cardiovascular Magnetic Resonance”

“…Hou et al evaluated the cardiac function of antiretroviral therapy-treated (ART-treated) males with AIDS using CMR imaging and found that those with a short disease duration may not develop obvious cardiac dysfunction as evaluated by routine CMR [10]. The findings suggest that routine CMR may not be necessary for ART-treated males with AIDS with a short disease duration, but it is important to consider individual patient characteristics and other factors when determining follow-up intervals.…”

Asymptomatic people with well-controlled HIV do not have abnormal left ventricular global longitudinal strain

“…A number of, although not all, echocardiographic studies in PWHIV have shown an increased prevalence of left ventricular (LV) systolic and/or diastolic dysfunction (7)(8)(9)(10)(11). Recent cardiac magnetic resonance imaging (CMR) studies have also shown left ventricular systolic and/or diastolic dysfunction in some (12)(13)(14) but not all studies (15,16). A large study evaluating cardiac chamber volumes in almost 600 PWHIV who were virologically suppressed on ART, and age-and sex-matched controls, using multidetector CT scans to measure cardiac volumes which were then indexed to body surface area (BSA) was reported.…”