Systolic function evaluated with cardiovascular magnetic resonance imaging in HIV-infected patients

Abstract

Background: Of all areas worldwide, sub-Saharan Africa is worst affected by the HIV and/or AIDS epidemic. Cardiovascular manifestations are very common and are a powerful contributor to mortality, but often go undetected. Cardiovascular magnetic resonance (CMR) is the most reliable method of assessing cardiac function and morphology and, with this in mind, we initiated a cross-sectional study comparing CMR-determined morphological and functional parameters in asymptomatic HIV-infected patients who were not yet on treatment and early in the disease, with HIV-uninfected control patients.Objectives: To ascertain whether there were any morphological abnormalities or systolic functional impairments on CMR in untreated asymptomatic HIV-infected patients, compared with HIV-uninfected control individuals.Methods: The CMR studies were performed using a 1.5-T whole-body clinical magnetic resonance 16-channel scanner (Achieva, Philips Medical Systems, Best, The Netherlands), using a cardiac five-element phased-array receiver coil (SENSE coil). Functional assessment was performed on 36 HIV-infected patients and the findings compared with 35 HIV-uninfected control patients who were matched for age and sex.Results: There was no significant difference in systolic function between the HIV-uninfected and the HIV-infected patients. The left ventricular end diastolic mass (LVEDM) was slightly higher in the HIV-infected group, but this was statistically insignificant.Conclusion: No significant differences were found regarding the CMR systolic functional analysis and morphological parameters between the HIV-infected and the healthy volunteers.

Association of HIV Infection With Cardiovascular Pathology Based on Advanced Cardiovascular Imaging

“…Furthermore, the association between specific ART regimens and myocardial fibrosis also remains underresearched. Two studies demonstrated higher levels of myocardial fibrosis in ART-naive patients compared with people living with HIV who have an established treatment regimen whereas another found no difference . In meta-regression analysis a significant and graded association between higher CD4 cell counts and lower rates of myocardial fibrosis was observed, consistent with the possibility that better HIV control may reduce myocardial pathology …”

“…Sixteen studies involving 5107 participants, 3446 of whom were HIV positive and 1661 were HIV negative, evaluated computed tomographic coronary angiography . Another 16 studies involving 1698 participants, 1203 of whom were HIV positive and 495 were HIV negative, evaluated cardiac MR imaging . Ten studies involving 681 participants, 435 of whom were HIV positive and 246 were HIV negative, evaluated vascular PET scans .…”

“…Of the 45 studies, 38 were conducted in high-income countries (49% in the US) with 7 in upper middle-income countries (Figure 1). No studies were performed in low-income countries. The study designs were cross-sectional (85%), prospective cohort (13%), and randomized clinical trial (2%).…”