Reduction in coronary and peripheral vasomotor function in patients with HIV after initiation of antiretroviral therapy: a longitudinal study with positron emission tomography and flow-mediated dilation
Reduction in coronary and peripheral vasomotor function in patients with HIV after initiation of antiretroviral therapy: a longitudinal study with positron emission tomography and flow-mediated dilation
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DOI：
10.1097/mnm.0b013e32833d82e6
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发表时间：
2010-10-01
影响因子：
1.5
通讯作者：
Kjaer, Andreas
中科院分区：
文献类型：
--
作者：
Kristoffersen, Ulrik Sloth;Wiinberg, Niels;Kjaer, Andreas
目的HIV感染者接受抗逆转录病毒治疗（ART）后心血管风险增加的机制尚不清楚。我们的目的是研究心脏灌注正电子发射断层扫描（PET）的冠状动脉内皮功能的患者与艾滋病毒启动ART。此外，血流介导的舒张（FMD）的肱动脉measured.Methods患者与艾滋病毒计划启动ART（n=12）被列入。术前及术后5周分别行（NH3）-N-13灌注PET和FMD扫描结果经脉压校正的静息心肌灌注无明显变化，与对照组比较，P值小于0.05者有显著性差异（P <0.05）。（1.22 +/- 0.07-1.09 +/- 0.05 ml/min/g组织，NS）或冷加压储备（1.18 +/- 0.08-1.27 +/- 0.05，NS）。然而，最大心肌灌注从2.50 +/- 0.25降至1.73 +/- 0.15 ml/min/g组织（P=0.009），心肌灌注储备从3.11 +/- 0.32降至2.48 +/- 0.25（P=0.042），降低了31%。FMD从8.68 +/-1.70%下降至4.58 +/- 0.93%（P=0.027）。硝酸甘油介导的血管舒张功能无明显变化（12.8 ± 1.0-14.4 ± 1.4%，NS）。结论在HIV感染者开始ART治疗后，通过冠状动脉灌注PET和FMD评估的内皮功能障碍的发展迹象在开始用药后早期就被发现。Nucl Med Commun 31：874-880（C）2010 Wolters Kluwer Health垂直栏Lippincott威廉姆斯& Wilkins。
Objectives The mechanisms underlying the increased cardiovascular risk in patients with HIV on antiretroviral therapy (ART) are not known. Our aim was to study the endothelial function of the coronary arteries by cardiac perfusion positron emission tomography (PET) in patients with HIV initiating ART. In addition, flow-mediated dilation (FMD) of the brachial artery was measured.Methods Patients with HIV scheduled to initiate ART (n=12) were included. (NH3)-N-13 perfusion PET and FMD scans were performed both before and 5 weeks (24-67 days) after initiation of ART. Data were compared with paired t-tests and a P value of less than 0.05 was considered significant.Results No changes were found in the pulse-pressure-corrected myocardial rest perfusion (1.22 +/- 0.07-1.09 +/- 0.05 ml/min/g tissue, NS) or cold pressor reserve (1.18 +/- 0.08-1.27 +/- 0.05, NS). However, the maximal myocardial perfusion decreased 31% from 2.50 +/- 0.25 to 1.73 +/- 0.15 ml/min/g tissue (P=0.009) and the myocardial perfusion reserve decreased 20% from 3.11 +/- 0.32 to 2.48 +/- 0.25 (P=0.042). FMD decreased from 8.68 +/- 1.70 to 4.58 +/- 0.93% (P=0.027). No change was observed in nitroglycerin-mediated dilation (12.8 +/- 1.0-14.4 +/- 1.4%, NS).Conclusion In patients with HIV initiating ART, signs of development of endothelial dysfunction assessed by coronary perfusion PET and FMD were found early after starting medication. Nucl Med Commun 31:874-880 (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.