Echocardiographic Abnormalities and Associated Factors in a Cohort of Asymptomatic HIV-Infected Patients
Echocardiographic Abnormalities and Associated Factors in a Cohort of Asymptomatic HIV-Infected Patients
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DOI：
10.1089/aid.2012.0096
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发表时间：
2013-01-01
影响因子：
1.5
通讯作者：
Santos, Jesus
中科院分区：
文献类型：
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作者：
Isasti, Guillermo;Perez, Isabel;Santos, Jesus
据报道，艾滋病毒患者超声心动图异常的患病率更高。我们的目的是确定这些异常的患病率及其相关因素。这是一项针对无症状HIV患者队列的观察性研究。记录了心血管相关因素和与艾滋病毒感染相关因素的数据。所有受试者均接受了经胸超声心动图检查。该研究包括196名患者，85.2%为男性，平均年龄46.4岁，平均HIV感染持续时间为123.8个月，27.6%为AIDS。在这些患者中，94.4%接受抗逆转录病毒治疗，其中92.5%的患者病毒载量检测不到。平均CD 4细胞计数为544/mm（3）。发现以下超声心动图异常：左心室（LV）肥大28.6%，LV舒张功能障碍19.9%，左心房（LA）扩张7.7%，右心室（RV）收缩功能障碍6.1%，肺动脉高压2.6%，RV扩张2%，（LV）收缩功能障碍1%。左室肥厚与糖尿病有关（OR 5.3，95% CI 1.8-15.3; p = 0.001），LV舒张功能不全随年龄增长（每增加5年的OR为4.4，95% CI为4.2-4.6; p = 0.0001），肥胖（OR 4.07，95% CI 1.6-10.0; p = 0.02），饮酒（OR 2.5，95% CI 1.07-6.2; p = 0.03）和较低的CD 4细胞计数（每10个CD 4细胞的OR小于10.02，95% CI 10.00-10.04; p = 0.008）和RV收缩功能障碍伴高血压（OR 5.4，95% CI 1.6-18.2; p = 0.005）。HIV患者的超声心动图异常很常见，尤其是左室肥厚和舒张功能障碍。需要进行涉及一般人群的前瞻性比较研究，以确定这些异常中艾滋病毒感染的流行率及其治疗。
HIV patients have been reported to have a greater prevalence of echocardiographic abnormalities. We aimed to determine the prevalence of these abnormalities and their associated factors. This was an observational study of a cohort of asymptomatic HIV patients. Data were recorded on factors of cardiovascular interest and those related to HIV infection. All the subjects underwent a transthoracic echocardiogram. The study included 196 patients, 85.2% men, mean age 46.4 years, with a mean duration of HIV infection of 123.8 months and 27.6% with AIDS. Of the patients, 94.4% were on antiretroviral therapy and 92.5% of these had an undetectable viral load. The mean CD4 cell count was 544/mm(3). The following echocardiographic abnormalities were found: left ventricular (LV) hypertrophy 28.6%, LV diastolic dysfunction 19.9%, left atrial (LA) dilatation 7.7%, right ventricular (RV) systolic dysfunction 6.1%, pulmonary hypertension 2.6%, RV dilatation 2%, and (LV) systolic dysfunction 1%. LV hypertrophy was associated with diabetes mellitus (OR 5.3, 95% CI 1.8-15.3; p = 0.001), LV diastolic dysfunction with age (OR for each extra 5 years 4.4, 95% CI 4.2-4.6; p = 0.0001), obesity (OR 4.07, 95% CI 1.6-10.0; p = 0.02), alcohol consumption (OR 2.5, 95% CI 1.07-6.2; p = 0.03) and lower CD4 cell count (OR for each 10 CD4 cells less 10.02, 95% CI 10.00-10.04; p = 0.008), and RV systolic dysfunction with hypertension (OR 5.4, 95% CI 1.6-18.2; p = 0.005). Echocardiographic abnormalities in HIV patients were common, especially LV hypertrophy and diastolic dysfunction. Prospective comparative studies involving the general population are needed to determine the prevalence of HIV infection and its treatment in these abnormalities.