Altered cardiac structure and function in newly diagnosed people living with HIV: a prospective cardiovascular magnetic resonance study after the initiation of antiretroviral treatment.
Altered cardiac structure and function in newly diagnosed people living with HIV: a prospective cardiovascular magnetic resonance study after the initiation of antiretroviral treatment.
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DOI：
10.1007/s10554-022-02711-y
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发表时间：
2023-01
影响因子：
2.1
通讯作者：
Herbst, Philip G.
中科院分区：
文献类型：
--
作者：
Robbertse, Pieter-Paul S.;Doubell, Anton F.;Steyn, Jan;Lombard, Carl J.;Talle, Mohammed A.;Herbst, Philip G.
关键词：
HIV相关性心肌病(HIVAC)是一种知之甚少的疾病，可能会沿着连续体发展。我们评估了一组新诊断的HIV感染者，并研究了ART开始后心脏异常的演变。我们招募了一组新诊断的、天真的艾滋病毒携带者和一组健康的未感染艾滋病毒的人。参与者接受了全面的心血管评估，包括心血管磁共振成像。HIV组开始接受抗逆转录病毒治疗，9个月后重新评估。在诊断时和9个月后比较研究组的心血管参数。单纯ART组(n = 66)左右两侧以身高为指标的舒张末容量均大于对照组(n = 22)(p <； 0.0 3)。与对照组相比，单纯组以身高为指标的左心室质量指数更大(p = 0.04)。单纯ART组的左、右室射血分数降低(p <； 0.03)，且与高艾滋病毒病毒载量呈负相关、非线性相关(p = 0.02)。9个月后左室内径增大(p = 0.04)，收缩功能无明显变化。HIV组的心包积液未消退率较高。HIV感染者在诊断时表现出脑室结构和功能的改变。高HIV病毒载量与左、右心功能不全相关。ART治疗后心脏参数和心包积液发生率没有改善。相反，随着左心室大小的增加，也出现了令人担忧的增加趋势。这些亚临床心脏异常可能代表着HIVAC连续体的一个阶段，如果原因不确定和解决，可能会进展为症状性疾病。网上版载有补充材料，可在10.1007/s10554-022-02711-y查阅。
HIV associated cardiomyopathy (HIVAC) is a poorly understood entity that may progress along a continuum. We evaluated a group of persons newly diagnosed with HIV and studied the evolution of cardiac abnormalities after ART initiation. We recruited a group of newly diagnosed, ART naïve persons with HIV and a healthy, HIV uninfected group. Participants underwent comprehensive cardiovascular evaluation, including cardiovascular magnetic resonance imaging. The HIV group was started on ART and re-evaluated 9 months later. The cardiovascular parameters of the study groups were compared at diagnosis and after 9 months. The ART naïve group’s (n = 66) left- and right end diastolic volume indexed for height were larger compared with controls (n = 22) (p < 0.03). The left ventricular mass indexed for height was larger in the naïve group compared with controls (p = 0.04). The ART naïve group had decreased left- and right ventricular ejection fraction (p < 0.03) and negative, non-linear associations with high HIV viral load (p = 0.02). The left ventricular size increased after 9 months (p = 0.04), while the systolic function remained unchanged. The HIV group had a high rate of non-resolving pericardial effusions. HIV infected persons demonstrate structurally and functionally altered ventricles at diagnosis. High HIV viral load was associated with left- and right ventricular dysfunction. Cardiac parameters and pericardial effusion prevalence did not show improvement with ART. Conversely, a concerning trend of increase was observed with left ventricular size. These subclinical cardiac abnormalities may represent a stage on the continuum of HIVAC that can progress to symptomatic disease if the causes are not identified and addressed. The online version contains supplementary material available at 10.1007/s10554-022-02711-y.
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影响因子：
1.7
作者：
Lilian, Rivka R.;Rees, Kate;Peters, Remco P.H.
通讯作者：
Peters, Remco P.H.
影响因子：
2.9
作者：
Khanna, Shaun;Bhat, Aditya;Tan, Timothy C.
通讯作者：
Tan, Timothy C.
影响因子：
9.7
作者：
Hsue, Priscilla Y.;Hunt, Peter W.;Bolger, Ann F.
通讯作者：
Bolger, Ann F.
DOI：
10.1177/0300060517708919
发表时间：
2017-12
期刊：
The Journal of international medical research
影响因子：
--
作者：
Chew KW;Liu CY;Ambale-Venkatesh B;Liao D;Horwich TB;Lima JAC;Bluemke DA;Paul Finn J;Butt AA;Currier JS
通讯作者：
Currier JS
DOI：
10.1186/s12968-015-0111-7
发表时间：
2015-04-18
期刊：
Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
影响因子：
--
作者：
Kawel-Boehm N;Maceira A;Valsangiacomo-Buechel ER;Vogel-Claussen J;Turkbey EB;Williams R;Plein S;Tee M;Eng J;Bluemke DA
通讯作者：
Bluemke DA