Review of cardiovascular magnetic resonance in human immunodeficiency virus-associated cardiovascular disease

Abstract

Despite ongoing advances in the treatment of patients with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS), they remain a major global public health concern conferring an increased risk of morbidity and mortality in affected individuals. This is, in part, because of the widespread dysfunction imposed by HIV and its treatment on the cardiovascular system, including the myocardium, valvular apparatus, pericardium and coronary, pulmonary and peripheral vasculature. In recent times, cardiovascular magnetic resonance (CMR) imaging has emerged as the gold standard tool for assessment of a variety of indications, allowing comprehensive characterisation of functional, morphological, metabolic and haemodynamic sequelae of several cardiovascular pathologies. Furthermore, continued advancement in imaging techniques has yielded novel insights into the underlying pathophysiology and guides future therapeutic strategies. In this article, we review the various clinical phenotypes of HIV-associated cardiovascular disease and highlight the utility of CMR in their assessment.

Influence of Diversity Nursing on Patients’ Rehabilitation in Cardiology Treatment

“…The use of these technical means can help doctors observe and understand the patient's condition and improve the efficiency of diagnosis and treatment and the recovery rate of the condition [ 22 , 23 ]. For some related theories and algorithms of medical imaging technology and image data processing technology, this article also makes some brief introductions [ 24 , 25 ].…”

The Role of Multimodality Imaging in HIV-Associated Cardiomyopathy

“…CMR can detect several components of inflammation, which include edema and fibrosis depending on the extent of cardiac involvement and stage of disease. Figure 1 shows CMR findings demonstrating fibrosis by late gadolinium enhancement (LGE) in a patient with HIV as well as markedly elevated myocardial T1 consistent with diffuse myocardial fibrosis ( 29 ).…”

“… Short-axis (A) , 2-chamber (B) , and 4-chamber (C) late gadolinium phase-sensitive inversion recovery images show linear mid-wall enhancement in the lateral wall of the LV (white arrows) in a patient with HIV. T1 map at the level of the mid-LV (D) shows a markedly elevated myocardial T1 time of 1,414 m/s (normal 1,052 m/s ± 23 m/s at 3 T) (E) consistent with diffuse myocardial fibrosis ( 29 ). …”

The hidden continuum of HIVassociated cardiomyopathy: A focussed review with case reports

“…These include the presence of inflammation, oedema, necrosis, fibrosis, infarction, infiltration and thrombosis. (14,15) Non-invasive measurement of tissue characteristics have led to the development of CMR-biomarkers. T1, T2 and T2* (T2 star) are magnetic resonance imaging (MRI) measurements that represent different tissue relaxation parameters following excitation by a radiofrequency pulse.…”

“…Various hypotheses have been proposed and involve chronic inflammation secondary to immune activation, post-infective cardiac autoimmunity, primary or secondary HIV myocarditis, immunodeficiency, opportunistic infections, complications of ART, nutritional deficiencies, traditional risk factors, as well as alcohol consumption and smoking. (6,9,14,19,(27)(28)(29)(30)(31)(32)(33) It is not known whether a genetic predisposition to HIVAC exists and limited research has been performed in this field. (34) In practice, the cause is most probably multifactorial and likely to represent a complex interplay of one or more of these processes.…”