Echocardiography and carotid intima-media thickness among asymptomatic HIV-infected adolescents in Thailand.
Echocardiography and carotid intima-media thickness among asymptomatic HIV-infected adolescents in Thailand.
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DOI：
10.1097/qad.0000000000000376
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发表时间：
2014-09-10
期刊：
影响因子：
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通讯作者：
Chokephaibulkit K
中科院分区：
文献类型：
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作者：
Chanthong P;Lapphra K;Saihongthong S;Sricharoenchai S;Wittawatmongkol O;Phongsamart W;Rungmaitree S;Kongstan N;Chokephaibulkit K
Objectives：To evaluate the carotid intima-media thickness（cIMT）in perinatally HIV infected adolescents and factors associated with cardiovascularabnormalities.Designs：A cross-sectional study was conducted in perinatally HIV infected adolescents who had no known cardiovascular conditions and healthy controls.Methods：经胸超声心动图和cIMT测量结果由儿科心脏病专家进行。结果：100例HIV感染者和50例健康青少年均被纳入研究。超声心动图显示总体收缩功能正常（左心室射血分数中位数为66 vs. 66%; P= 0.825）。两组间颈总动脉和颈内动脉的平均总体cIMT无差异（0.373 vs. 0.371; P= 0.744）。在HIV感染的青少年中，那些接受含蛋白酶底物方案的人cIMT增加（0.364 vs. 0.381 mm; P= 0.009）。在接受蛋白酶抑制剂治疗超过6个月的患者中，52%的患者出现高胆固醇血症，但在从未接受过蛋白酶抑制剂的患者中，仅21%的患者出现高胆固醇血症（比值比4.0，95%置信区间1.6-9.7，P= 0.002）。目前的HIV-RNA、CD 4+、BMI、性别、胆固醇和低密度脂蛋白胆固醇与cIMT增加无关。血清高敏C-反应蛋白和N-末端脑钠肽前体组之间没有差异，并不与心脏abnormals.Conclusions：围产期HIV感染的青少年有可比的心肌功能和健康青少年相似的cIMT测量。然而，在接受基于蛋白酶抑制剂的方案的艾滋病毒感染青少年中发现了高甘油三酯血症和cIMT增加。需要长期随访以评估该人群中HIV相关心血管疾病的风险。
Objectives:To evaluate the carotid intima–media thickness (cIMT) in perinatally HIV-infected adolescents and factors associated with cardiovascular abnormalities.Designs:A cross-sectional study was conducted in perinatally HIV-infected adolescents who had no known cardiovascular condition and healthy controls.Methods:Transthoracic echocardiogram and cIMT measurements were taken by pediatric cardiologists. Serum lipid profiles, high-sensitivity C-reactive protein and N-terminal pro-brain natriuretic peptide were measured.Results:Hundred HIV-infected and 50 healthy adolescents were enrolled. Echocardiograms revealed overall normal systolic function (median left-ventricular ejection fraction 66 vs. 66%; P= 0.825). The mean overall cIMTs of common carotid arteries and internal carotid arteries were not different between the groups (0.373 vs. 0.371; P= 0.744). Among the HIV-infected adolescents, those who had been receiving protease inhibitor-containing regimens had an increased cIMT (0.364 vs. 0.381 mm; P= 0.009). Hypertriglyceridemia was found in 52% of those who had received protease inhibitors for more than 6 months, but only in 21% of those who had never received protease inhibitors (odds ratio 4.0, 95% confidence interval 1.6–9.7, P= 0.002). Current HIV-RNA, CD4+, BMI, sex, cholesterol and low-density lipoprotein-cholesterol were not associated with increased cIMT. Serum high-sensitivity C-reactive protein and N-terminal pro-brain natriuretic peptide were not different between the groups and not associated with cardiac abnormalities.Conclusions:Perinatally HIV-infected adolescents had comparable myocardial function and similar cIMT measurements to healthy adolescents. However, hypertriglyceridemia and increased cIMT were found in HIV-infected adolescents receiving protease inhibitor-based regimens. Longer-term follow-up is needed to evaluate HIV-associated cardiovascular disease risk in this population.