Factors influencing left ventricular diastolic dysfunction on echocardiography of people living with HIV in Kunming, China

Abstract

Background The widespread use of antiretroviral therapy has prolonged the survival of people living with HIV (PLWH). Among these patients, co-existing cardiovascular diseases, particularly left ventricular diastolic dysfunction (LVDD), are receiving increasing attention. Methods We recruited 386 patients in the PLWH group and 386 sex- and age (± 3 years)-matched individuals in the HIV-negative group, and used logistic regression to determine the risk factors of LVDD. Results Compared to the HIV-negative group, PLWH had a significantly higher prevalence of smoking ( p < .001), alcohol consumption ( p < .001), hypertension ( p = .002), diabetes ( p = .020), and hyperlipidemia ( p < .001) and a lower prevalence of body mass index (BMI) ≥ 24.0 kg/m2 ( p < .001). The prevalence of LVDD on echocardiography was significantly higher in PLWH than in the HIV-negative group (25.9% vs 16.1%, p = .001). The multivariate analysis showed that non-youth (OR = 8.666; 95%CI = 4.310-17.459; p < .001), BMI ≥ 24.0 kg/m2 (OR = 1.992; 95% CI = 1.007-3.939; p = .048), hypertension (OR = 1.888; 95% CI = 1.044-3.415; p = .036), hyperlipidemia (OR = 1.911; 95% CI = 1.068-3.418; p = .029), and HIV infection (OR = 2.003; 95%CI = 1.341-2.992; p = .001) were risk factors for LVDD. Conclusion The rate of echocardiographic abnormalities was higher in PLWH. LVDD was associated with non-youth, BMI ≥ 24.0 kg/m2, hypertension, hyperlipidemia, and living with HIV.

Unveiling the Heart of the Matter: Echocardiographic Insights into Diastolic Function and Left Ventricular and Atrial Changes in HIV Patients with Controlled Viremia

“…HIV-specific causes of DD include inflammation, particularly monocyteand macrophage-derived fibrosis; HIV-associated microvascular dysfunction; and endothelial injury [6]. DD occurs more often in people living with HIV (PLWH) than in the general population, with DD prevalence in PLWH ranging from 8% to 25.9% [9][10][11]. As HF is more frequent and appears earlier in PLWH than in the HIV-negative population (especially HFrEF) [12], active screening for early echocardiographic changes may allow early identification and intervention.…”