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Myocardial deformation imaging unmasks subtle left ventricular systolic dysfunction in asymptomatic and treatment-naïve HIV patients

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Abstract

Background

Patients infected by the human immunodeficiency virus (HIV) and receiving highly active antiretroviral therapy have a higher incidence of cardiovascular disease than healthy subjects, but little is known about cardiac function in asymptomatic and treatment-naïve patients. We sought to study cardiac function in asymptomatic HIV-infected, treatment-naïve patients.

Methods

We studied 41 HIV-infected and treatment-naïve patients and 20 age- and sex-matched healthy controls. Patients with cardiac symptoms, history of cardiac disease or NT-proBNP >100 pg/mL were excluded. We addressed cardiac function using standard echocardiography along with tissue Doppler (TDI) measurements, including strain/strain rate assessment.

Results

Standard echocardiographic parameters did not differ between groups, except for transmitral E wave velocity (64.8 ± 14 cm/s in HIV vs 76.1 ± 10 cm/s in controls, p = 0.002). In contrast, TDI mitral and tricuspid annulus s velocity and all strain/strain rate measurements were significantly lower in HIV patients: s lateral, 10.2 ± 2.4/11.3 ± 0.7, p = 0.011; s septal, 8.1 ± 1.6/8.7 ± 0.8, p = 0.045; s tricuspid, 13.4 ± 2.3/14.9 ± 1.3, p = 0.002; strain/strain rate, septal (strain/strain rate, 15.1 ± 5.7/−0.9 ± 0.3, 25.3 ± 1.7/−1.9 ± 0.2, p < 0.001), anterior (16.7 ± 3/−1.0 ± 0.1, 26.7 ± 1.7/−1.9 ± 0.2, p < 0.001), lateral (16.0 ± 6/−1.0 ± 0.1, 27.5 ± 1.8/−2.2 ± 0.3, p < 0.001) and posterior (15.2 ± 5.8/−1.0 ± 0.2, 26.2 ± 1.8/−2.2 ± 0.3, p < 0.001) left ventricular wall.

Conclusions

HIV infection itself is accompanied by subclinical systolic dysfunction, not apparent to standard echocardiography that can be unmasked though using sensitive echocardiographic techniques.

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Authors and Affiliations

  1. Department of Cardiology, Athens General Hospital “G. Gennimatas”, Athens, Greece

    Apostolos Karavidas, Vassiliki Matzaraki, Nikolaos Papoutsidakis, Georgios Leventopoulos, George Lazaros, Anastasia Perpinia, Sophia Arapi & Vlasios Pyrgakis

  2. First Department of Internal Medicine, Athens General Hospital “G. Gennimatas”, Athens, Greece

    George Xylomenos, Nikolaos Paisios & Panagiotis Gargalianos

  3. Heart Failure Unit, Department of Cardiology, Athens University Hospital “Attikon”, 1 Rimini St, Haidari, 12461, Athens, Greece

    Dimitrios Farmakis & John Parissis

Authors
  1. Apostolos Karavidas
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  2. George Xylomenos
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  3. Vassiliki Matzaraki
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  4. Nikolaos Papoutsidakis
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  5. Georgios Leventopoulos
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  6. Dimitrios Farmakis
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  7. George Lazaros
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  8. Anastasia Perpinia
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  9. Sophia Arapi
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  10. Nikolaos Paisios
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  11. John Parissis
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  12. Vlasios Pyrgakis
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  13. Panagiotis Gargalianos
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Corresponding author

Correspondence to Dimitrios Farmakis.

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Karavidas, A., Xylomenos, G., Matzaraki, V. et al. Myocardial deformation imaging unmasks subtle left ventricular systolic dysfunction in asymptomatic and treatment-naïve HIV patients. Clin Res Cardiol 104, 975–981 (2015). https://doi.org/10.1007/s00392-015-0866-8

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  • DOI: https://doi.org/10.1007/s00392-015-0866-8

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