Editorial for “Cardiac MRI‐Based Assessment of Myocardial Injury in Asymptomatic People Living With Human Immunodeficiency Virus: Correlation With nadir CD4 Count”

Abstract

A magnetic personality doesn't necessarily indicate a good heart Laura Linney R ecent studies have reported that the risk of cardiovascular disease has increased more than 2-fold in people living with human immunodeficiency virus (PLWH), reaching a burden of 80% in 2030. [1][2][3] In this issue of the journal, the authors used a sample of 130 people to explore whether differences in cardiac magnetic resonance imaging (MRI) findings were observed between asymptomatic PVWH patients (N = 80) and controls (N = 50). The inclusion criteria for the PLHIV group were adult patients receiving combination antiretroviral therapy (ART), and the exclusion criteria were no prior history of the following: acquired immune deficiency syndrome (AIDS)-related complications, hypertrophic cardiomyopathy, and myocardial infarction. All patients underwent 3.0-T MRI scans (MAGNETOM Verio, Siemens Healthcare, Erlangen, Germany). 4 Significantly higher native myocardial T1 and T2 values, but no significant difference in native T2* values, were observed for the asymptomatic PVWH patients. Correlation analysis showed that native T1 increment in PLHIV with subclinical myocardial injury, a negative correlation was found with nadir CD4+ T cell count. In the regression analysis, nadir CD4+ T cell count <500 cells/mm 3 was associated with greater risks of subclinical myocardial injury. 4 However, limitations of the study should be recognized. For example, the proportion of smokers was significantly higher in asymptomatic PVWH patients and it is thus conceivable that many of the incident cases of myocardial infarction may partly be mediated by smoking status. Moreover, many parameters that can influence cardiovascular outcomes, including waist circumference, inflammatory biomarkers (C-reactive protein, interleukin-6), cardiac biomarkers such as B-type natriuretic peptide (BNP)