Echocardiography detects myocardial damage in AIDS: prospective study in 102 patients

Abstract

Few data are available about cardiac involvement in AIDS. We examined 102 consecutive patients with AIDS diagnosed clinically and serologically (Walter Reed Stage 5 and 6), by means of TM and cross-sectional echocardiography with the aim of detecting cardiac abnormalities. None of the patients had overt clinical signs of heart failure. Fifty-five (54%) patients showed persistent tachycardia, diminished left ventricular (LV) wall thickness (mean 7.6 +/- 0.2 mm) and decreased percentage LV fractional shortening (27 +/- 5). In 42 (41%) there was a globular and poorly contracting LV. Thirty-nine (38%) patients had pericardial effusion which was moderate in 30 and small in nine. In four patients, valvular endocarditic vegetation was shown--on the tricuspid valve in three, on the aortic valve in one: all of them were drug addicts; in three (2.9%) patients a cardiac mass was found which proved to be a localization of Kaposi's sarcoma in two. Twenty-five (24.5%) patients died; necropsy showed cardiac chamber dilation, and thin LV walls in 18. On microscopic examination, myocardial fibrosis and lymphocyte infiltration with cell necrosis were observed. We conclude that cardiac abnormalities are common in AIDS. Impairment in LV contractility as assessed from fractional shortening appears to be the most common echocardiographic finding, followed by LV wall thinning, pericardial effusion and eventually by LV cavity dilation. This evolution is suggestive of myocardial damage and supports the hypothesis that dilated cardiomyopathy may be a cardiac complication of AIDS.

Study of cardiovascular manifestations in patients of HIV- its correlation with CD4 count and the ART regimen prescribed

“…Similar findings have been reported by other workers. 13,28,29 Though echocardiography seems to be a useful technique for the early recognition and treatment of cardiac dysfunction in such patients; clinico-pathological studies may help to clarify the role of HIV virus and opportunistic infections in the pathogenesis of cardiac abnormalities found in HIV infected patients.…”

Manifestações cardiovasculares em pacientes com infecção pelo vírus da imunodeficiência humana

“…In a five-year prospective study with asymptomatic HIV patients, the incidence of dilated cardiomyopathy was 15.9/1,000 29 . Echocardiographic studies showed early diastolic dysfunction in up to 15% of patients with HIV infection 30,31 . As cardiomyopathy advances, diffuse hypokinesia, overall dilation of the chambers and systolic dysfunction are observed 32 .…”

“…Clinically, patients are similar to non-infected individuals and in some cases the echocardiographic examination can detect the infection while the patient is still in the asymptomatic phase, usually with isolated diastolic dysfunction 30,31 . Recommendation of the echocardiogram as a routine and screening measure in HIV-positive patients is unclear.…”

Impact of CD4 + lymphocyte count on left ventricular systolic function in newly diagnosed HAART naïve HIV/AIDS patients seen at University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State

“…[7][8][9] Left Ventricular (LV) dysfunction has also been described in patients with human immunodeficiency virus infection. [10][11] For instance; both diastolic and systolic dysfunctions have been shown to be present even in asymptomatic seropositive carriers at the early stage of HIV infection. [12][13] Danbauchi et al found that 10% of the studied subjects had diastolic dysfunction and 3.6% had depressed ejection fraction on echocardiography after 1 to 2 years of ARV treatment.…”