Symptomatic cardiac dysfunction in children with human immunodeficiency virus infection

Stewart, Julian M.; Kaul, Aditya; Gromisch, Donald S.; Reyes, Eduardo; Woolf, Paul K.; Gowitz, Michael H

doi:10.1016/0002-8703(89)90668-6

Cited by 59 publications

(16 citation statements)

References 3 publications

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“…[1][2][3][4][5] Autopsy studies have documented pathologic cardiac findings in some children with HIV infection. 1,6,7 The virus itself has been detected in myocardial cells as well as pericardial fluid in HIV-infected children.…”

Section: Author Manuscriptmentioning

confidence: 99%

Cardiac Complications in Children With Human Immunodeficiency Virus Infection

et al. 1999

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Objective-Although numerous cardiac abnormalities have been reported in HIV-infected children, precise estimates of the incidence of cardiac disease in these children are not wellknown. The objective of this report is to describe the 2-year cumulative incidence of cardiac abnormalities in HIV-infected children.Methodology: Design-Prospective cohort (Group I) and inception cohort (Group II) study design.Setting-A volunteer sample from 10 university and public hospitals.Participants-Group I consisted of 205 HIV vertically infected children enrolled at a median age of 22 months. This group was comprised of infants and children already known to be HIVinfected at the time of enrollment in the study. Most of the children were African-American or Copyright © 1999 by the American Academy of Pediatrics.Reprint requests to (T.J.S.) Babies and Children's Hospital-2 North, Columbia-Presbyterian Medical Center, 630 W 168th St, New York, NY 10032., tjs1@columbia.edu. a Dr Lipshultz' current affiliation is with the Division of Pediatric Cardiology, Children's Hospital at Strong, University of Rochester Medical Center, Rochester, NY.This study was presented in part at the Society for Pediatric Research, May 10, 1995; San Diego, CA. HHS Public Access Author manuscriptPediatrics. Author manuscript; available in PMC 2015 March 13. Published in final edited form as:Pediatrics. 1999 August ; 104(2): e14. Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptHispanic and 89% had symptomatic HIV infection at enrollment. The second group included 611 neonates born to HIV-infected mothers, enrolled during fetal life or before 28 days of age (Group II). In contrast to the older Group I children, all the Group II children were enrolled before their HIV status was ascertained.Interventions-According to the study protocol, children underwent a series of cardiac evaluations including two-dimensional echocardiogram and Doppler studies of cardiac function every 4 to 6 months. They also had a 12-or 15-lead surface electrocardiogram (ECG), 24-hour ambulatory ECG monitoring, and a chest radiograph every 12 months.Outcome Measures-Main outcome measures were the cumulative incidence of an initial episode of left ventricular (LV) dysfunction, cardiac enlargement, and congestive heart failure (CHF). Because cardiac abnormalities tended to cluster in the same patients, we also determined the number of children who had cardiac impairment which we defined as having either left ventricular fractional shortening (LV FS) ≤25% after 6 months of age, CHF, or treatment with cardiac medications.Results: Cardiac Abnormalities-In Group I children (older cohort), the prevalence of decreased LV function (FS ≤25%) was 5.7% and the 2-year cumulative incidence (excluding prevalent cases) was 15.3%. The prevalence of echocardiographic LV enlargement (LV enddiastolic dimension z score >2) at the time of the first echocardiogram was 8.3%. The cumulative incidence of LV enddiastolic enlargement was 11.7% after 2 years.The cumulative incidence of...

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Section: Author Manuscriptmentioning

confidence: 99%

Cardiac Complications in Children With Human Immunodeficiency Virus Infection

et al. 1999

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“…4,10,15,[20][21][22][37][38][39][40] Cardiac studies performed on HIV-1 infected children provided greater understanding of the evolution and clinical management of the diseased heart. However, in the reviewed literature, we found no longitudinal study correlating cardiac changes and progression of the infection, either clinically or immunologically.…”

Section: Discussionmentioning

confidence: 99%

“…Childhood mortality due to cardiac complications ranges from 1% to 9%. 2,4,8,10,[12][13][14][15][16][17][18][19][20][21][22][23] The ever-increasing number of children born to HIVpositive mothers, coupled with the complex etiopathogenesis of heart involvement and the need for further understanding of the natural history of clinical cardiac manifestations during childhood, led us to study children exposed perinatally to HIV-1. This is an eightyear clinical, electrocardiographic, and echocardiographic follow-up study.…”

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confidence: 99%

Estudo cardiológico longitudinal em crianças expostas ao vírus da imunodeficiência humana tipo 1 por via perinatal

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et al. 2005

Arq. Bras. Cardiol.

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“…3,4 Mortality in HIV patients has also been reported to be substantially due to cardiomyopathy with up to 6 fold higher rate of death in HIV+ children. 5 Minimal left ventricular dysfunction in children was associated with 55% mortality in 5 years follow up. 6 The same rates have been reported in adult populations.…”

Section: Introductionmentioning

confidence: 98%

Cardiac manifestations in HIV patients and their correlation with CD4 count

et al. 2017

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Background: The introduction of highly active antiretroviral therapy (HAART) has significantly improved the clinical evolution of human immunodeficiency virus (HIV)/AIDS disease, with an increased survival of infected patients. With advances in the management of patients living with HIV and AIDS, not only survival has increased but manifestations of late stage HIV infection are encountered more often including cardiovascular complications. Objectives were to determine the prevalence and characteristics of cardiac manifestations in patients with HIV infection, and to correlate the cardiac manifestations with CD4 count.Methods: 115 HIV-positive cases and 30 healthy control subjects were evaluated by detailed history and general physical examination. CD4 was done for all patients using flowcytometry using a BD FACS Count system. All patients were evaluated using M Mode and two-dimensional transthoracic echocardiography and colour flow doppler examination.Results: Male to female ratio was1.6:1in cases. The most common symptoms were cough (54.78%), palpitations (10%), shortness of breath (52%), chest pain on exertion (18.0%) and ankle swelling (21.0%). Echocardiographic abnormalities were found in 63% of the cases compared with 6% in the controls. 18 (15.65%) patients had dilated cardiomyopathy, 17 (15%) pericardial effusion, 16 (14%) pulmonary artery hypertension, 17 (15%) mitral valve prolapses and 25 (22%) had reduced ejection fraction compared with none of controls. 54 (47%) cases had diastolic dysfunction compared with 3 (10%) controls and 40 (35%) cases had reduced fractional shortening (≤27%) compared 4 (13%) controls. Significant statistical positive correlation was not observed between low CD4 count and echocardiographic abnormalities. Pericardial effusion was seen more in patients with CD4 count below 200.Conclusions: Cardiovascular abnormalities in HIV infected patients are common and can occur without any clinical manifestation. There was no significant association between CD4 count and any cardiac manifestation.

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Symptomatic cardiac dysfunction in children with human immunodeficiency virus infection

Cited by 59 publications

References 3 publications

Cardiac Complications in Children With Human Immunodeficiency Virus Infection

Cardiac Complications in Children With Human Immunodeficiency Virus Infection

Estudo cardiológico longitudinal em crianças expostas ao vírus da imunodeficiência humana tipo 1 por via perinatal

Cardiac manifestations in HIV patients and their correlation with CD4 count

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