Abstract
Heart failure (HF) is a major cause of morbidity and mortality globally. Epidemiologic studies have shown that people living with HIV (PLHIV) have 1.5–2-fold higher risk of heart failure compared with uninfected persons. This may be directly related to the level of HIV control and CD4 count. Women with HIV appear to have a higher risk of HF compared to men with HIV. The pathophysiology of HF in PLHIV is likely multifactorial including direct effects of the HIV virus, comorbid conditions, chronic inflammation, and medications. To date, there are no randomized clinical trials focused on the management of HF in PLHIV; therefore, HF management guidelines for the general population may be applied to PLHIV. There are special considerations for PLHIV undergoing device and advanced HF therapies. Studies have shown that HF therapies may be underutilized in PLHIV resulting in increased risk of adverse outcomes. This chapter discusses the epidemiology, pathophysiology, pharmacologic and non-pharmacologic management, and outcomes of heart failure in PLHIV.
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References
Patel T, Al-Kindi S, Oliveira G. Trends in cardiac imaging in patients receiving cardiotoxic chemotherapy. J Am Coll Cardiol. 2017;11:1498.
Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, Chiuve SE, Cushman M, Delling FN, Deo R, de Ferranti SD, Ferguson JF, Fornage M, Gillespie C, Isasi CR, Jimenez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Lutsey PL, Mackey JS, Matchar DB, Matsushita K, Mussolino ME, Nasir K, O’Flaherty M, Palaniappan LP, Pandey A, Pandey DK, Reeves MJ, Ritchey MD, Rodriguez CJ, Roth GA, Rosamond WD, Sampson UKA, Satou GM, Shah SH, Spartano NL, Tirschwell DL, Tsao CW, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P. American Heart Association Council on E, Prevention Statistics C and Stroke Statistics S. Heart Disease and Stroke Statistics-2018 update: a report from the American Heart Association. Circulation. 2018;137:e67–e492.
Gulati G, Heck SL, Ree AH, et al. Prevention of cardiac dysfunction during adjuvant breast cancer therapy (PRADA): a 2 × 2 factorial, randomized, placebo-controlled, double-blind clinical trial of candesartan and metoprolol. Eur Heart J. 2016;37:1671–80.
Cohen IS, Anderson DW, Virmani R, Reen BM, Macher AM, Sennesh J, DiLorenzo P, Redfield RR. Congestive cardiomyopathy in association with the acquired immunodeficiency syndrome. N Engl J Med. 1986;315:628–30.
Remick J, Georgiopoulou V, Marti C, Ofotokun I, Kalogeropoulos A, Lewis W, Butler J. Heart failure in patients with human immunodeficiency virus infection: epidemiology, pathophysiology, treatment, and future research. Circulation. 2014;129:1781–9.
Cerrato E, D’Ascenzo F, Biondi-Zoccai G, et al. Cardiac dysfunction in pauci symptomatic human immunodeficiency virus patients: a meta-analysis in the highly active antiretroviral therapy era. Eur Heart J. 2013;34:1432–6.
Butt AA, Chang CC, Kuller L, et al. Risk of heart failure with human immunodeficiency virus in the absence of prior diagnosis of coronary heart disease. Arch Intern Med. 2011;171:737–43.
Al-Kindi SG, ElAmm C, Ginwalla M, Mehanna E, Zacharias M, Benatti R, Oliveira GH, Longenecker CT. Heart failure in patients with human immunodeficiency virus infection: Epidemiology and management disparities. Int J Cardiol. 2016;218:43–6.
Thiara DK, Liu CY, Raman F, Mangat S, Purdy JB, Duarte HA, Schmidt N, Hur J, Sibley CT, Bluemke DA, Hadigan C. Abnormal myocardial function is related to myocardial steatosis and diffuse myocardial fibrosis in HIV-infected adults. J Infect Dis. 2015;212:1544–51.
Oliveira GH, Al-Kindi SG, Hoimes C, Park SJ. Characteristics and survival of malignant cardiac tumors: a 40-year analysis of >500 patients. Circulation. 2015;132:2395–402.
Al-Kindi SG, Kim CH, Morris SR, Freeman ML, Funderburg NT, Rodriguez B, McComsey GA, Dalton JE, Simon DI, Lederman MM, Longenecker CT, Zidar DA. Elevated Red Cell Distribution Width (RDW) identifies elevated cardiovascular disease risk in patients with HIV infection. J Acquir Immune Defic Syndr. 2017;74:298–302.
Daley BG, Miranda DF, Tetekpor N, Baker JV, Simegn M. Abstract 11608: characteristics of incident heart failure in HIV disease at an urban HIV clinic and hospital from 2007–2014. Circulation. 2015;132:A11608.
Reinsch N, Neuhaus K, Esser S, Potthoff A, Hower M, Brockmeyer NH, Erbel R, Neumann T. Prevalence of cardiac diastolic dysfunction in HIV-infected patients: results of the HIV-HEART study. HIV Clin Trials. 2010;11:156–62.
Hsue PY, Hunt PW, Ho JE, Farah HH, Schnell A, Hoh R, Martin JN, Deeks SG, Bolger AF. Impact of HIV infection on diastolic function and left ventricular mass. Circ Heart Fail. 2010;3:132–9.
Felker GM, Thompson RE, Hare JM, Hruban RH, Clemetson DE, Howard DL, Baughman KL, Kasper EK. Underlying causes and long-term survival in patients with initially unexplained cardiomyopathy. N Engl J Med. 2000;342:1077–84.
Reinsch N, Neuhaus K, Esser S, Potthoff A, Hower M, Mostardt S, Neumann A, Brockmeyer NH, Gelbrich G, Erbel R, Neumann T. Are HIV patients undertreated? Cardiovascular risk factors in HIV: results of the HIV-HEART study. Eur J Prev Cardiol. 2012;19:267–74.
Janjua SA, Triant VA, Addison D, Szilveszter B, Regan S, Staziaki PV, Grinspoon SA, Hoffmann U, Zanni MV and Neilan TG. HIV Infection and Heart Failure Outcomes in Women. J Am Coll Cardiol. 2017;69:107–108.
Holloway CJ, Ntusi N, Suttie J, et al. Comprehensive cardiac magnetic resonance imaging and spectroscopy reveal a high burden of myocardial disease in HIV patients. Circulation. 2013;128:814–22.
Howard LC, Liu CY, Purdy JB, Walter P, Bluemke DA, Hadigan C. Lipolytic rate associated with intramyocardial lipid in an HIV cohort without increased lipolysis. J Clin Endocrinol Metab. 2016;101:151–6.
Engstrom K, Garcia M. Initial antiretroviral therapy with protease inhibitors is associated with increased risk of heart failure in HIV-infected patients. J Am Coll Cardiol. 2014;63:A955.
Lundgren JD, Battegay M, Behrens G, et al. European AIDS Clinical Society (EACS) guidelines on the prevention and management of metabolic diseases in HIV. HIV Med. 2008;9:72–81.
Baker JV, Huppler Hullsiek K, Prosser R, Duprez D, Grimm R, Tracy RP, Rhame F, Henry K, Neaton JD. Angiotensin converting enzyme inhibitor and HMG-CoA reductase inhibitor as adjunct treatment for persons with HIV infection: a feasibility randomized trial. PLoS One. 2012;7:e46894.
Wever-Pinzon O, Bangalore S, Romero J, Silva Enciso J, Chaudhry FA. Inotropic contractile reserve can risk-stratify patients with HIV cardiomyopathy: a dobutamine stress echocardiography study. JACC Cardiovasc Imaging. 2011;4:1231–8.
Romero-León JM, Gálvez-Contreras MC, Díez-García LF. Symptomatic bradycardia and heart failure triggered by ivabradine in a patient receiving antiretroviral therapy. Rev Esp Cardiol. 2016;69:529–30.
Tseng ZH, Secemsky EA, Dowdy D, Vittinghoff E, Moyers B, Wong JK, Havlir DV, Hsue PY. Sudden cardiac death in patients with human immunodeficiency virus infection. J Am Coll Cardiol. 2012;59:1891–6.
Boersma L, Burke MC, Neuzil P, Lambiase P, Friehling T, Theuns DA, Garcia F, Carter N, Stivland T, Weiss R. Infection and mortality after implantation of a subcutaneous ICD after transvenous ICD extraction. Heart Rhythm. 2016;13(1):157–64.
Jessup M, Brozena S. Heart failure. N Engl J Med. 2003;348:2007–18.
Uriel N, Nahumi N, Colombo PC, Yuzefpolskaya M, Restaino SW, Han J, Thomas SS, Garan AR, Takayama H, Mancini DM, Naka Y, Jorde UP. Advanced heart failure in patients infected with human immunodeficiency virus: is there equal access to care? J Heart Lung Transplant. 2014;33:924–30.
Pamboukian SV, Baddley JW, Kirklin JK, Cantor RS, Naftel DC, Miller JD, Teuteberg JJ. Outcomes of mechanical circulatory support in HIV infected patients from the INTERMACS registry. J Heart Lung Transplant. 2014;33:S209.
Calabrese LH, Albrecht M, Young J, McCarthy P, Haug M, Jarcho J, Zackin R. Successful cardiac transplantation in an HIV-1–infected patient with advanced disease. N Engl J Med. 2003;348:2323–8.
Agüero F, Castel MA, Cocchi S, et al. An update on heart transplantation in human immunodeficiency virus–infected patients. Am J Transplant. 2016;16:21–8.
Muller E, Barday Z, Mendelson M, Kahn D. HIV-positive–to–HIV-positive kidney transplantation – results at 3 to 5 years. N Engl J Med. 2015;372:613–20.
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Al-Kindi, S.G., Longenecker, C.T. (2019). Epidemiology and Clinical Approach to Heart Failure in Patients with HIV. In: Myerson, M., Glesby, M. (eds) Cardiovascular Care in Patients With HIV. Springer, Cham. https://doi.org/10.1007/978-3-030-10451-1_10
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DOI: https://doi.org/10.1007/978-3-030-10451-1_10
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