Ventricular and atrial functions assessed by speckle‐tracking echocardiography in patients with human immunodeficiency virus

Abstract

Purpose: Antiretroviral therapy (ART) has dramatically changed the clinical manifestation of human immunodeficiency virus (HIV) associated cardiomyopathy from severe left ventricular (LV) systolic dysfunction to a pattern of subclinical cardiac dysfunction. The aim of this study was to evaluate by speckle tracking echocardiography (STE) LV, right ventricular (RV), and biatrial functions in HIV-infected patients under different ART combinations. Methods: We consecutively included 128 HIV-infected patients (mean age 44.2 ± 10.1 years, 110 males) and 100 controls (mean age 42.1 ± 9.4 years, 83 males).Ventricular and atrial functions were assessed by both conventional and STE.Results: Although there was not any significant difference in conventional echocardiographic variables, HIV-infected patients had significantly lower LV global longitudinal strain (GLS), RV GLS, left atrial (LA) reservoir and conduit strain, and right atrial conduit strain. HIV patients receiving integrase strand transfer inhibitors and protease inhibitors (PI) had significantly lower LV GLS and LA conduit strain, while patients receiving non-nucleoside reverse transcriptase inhibitors and PI had significantly lower RV GLS than controls. CD4 count at the time of echocardiography was strongly correlated with LV GLS (r = .619, P < .001) and RV GLS (r = .606, P < .001). Conclusion:Biventricular and atrial functions are subclinically impaired in HIVinfected patients. ART regimen may also affect myocardial functions.

Multi-Parametric Diagnostic Approach and Potential Markers of Early Onset Subclinical Cardiovascular Disease in a Cohort of Children, Adolescents and Young Adults Vertically Infected with HIV on cART

“…Surprisingly, we found 29% of patients with GLS values below the lower normal limit (−19%). Similar data were recently found in adult HIV patients [26]. These findings could be due both to the effects of HIV infection itself on myocardial structure and vasculature and to the effects of chronic immune activation and early cellular senescence.…”

“…Interestingly, it was possible to point out a correlation between GLS and cIMT (r = 0.38, p = 0.03), indicating the presence of diffuse or multi-organ endothelial dysfunction (Figure 2). There are concerns that ART may induce atherosclerotic process and is associated with an increase in peripheral and coronary artery disease in these patients, leading to impairment in cardiac function [26]. The etiology of subclinical endothelial diseases might be multifactorial.…”

Echocardiography Assessment of Cardiac Function in Adults Living with HIV: A Speckle Tracking Study in the Era of Antiretroviral Therapy

“…Similar findings were reported by Cincin et al in a larger study, including 120 patients with HIV. However, the patients were significantly older compared with our study group and had associated hypertension, dyslipidemia and diabetes [16]. Peak segmental LS dispersion was proposed as an indicator of myocardial heterogeneity and is considered a valuable assessor of arrhythmic risk in various cardiac diseases [17,18].…”

Risk factors and diagnostic value of urinary N-terminal pro-brain natriuretic peptide for verification of heart failure in human immunodeficiency virus-infected patients

“…В других работах продемонстрировано, что у больных с ВИЧ-инфекцией и ХСН преимущественно определяется сохраненная и промежуточная ФВ ЛЖ [21], как и найдено в нашем исследовании. Но все исследователи единодушны в том, что ВИЧ-инфекция ассоциирована с ДД ЛЖ, ГЛЖ и увеличением ЛП по данным методов спекл-трекинг при проведении ЭхоКГ и магнитнорезонансной томографии [22,23].…”