Echocardiographic Findings Among Virally Suppressed HIV-Infected Aging Asians Compared with HIV-Negative Individuals
Echocardiographic Findings Among Virally Suppressed HIV-Infected Aging Asians Compared with HIV-Negative Individuals
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DOI：
10.1097/qai.0000000000002456
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发表时间：
2020-11-01
影响因子：
3.6
通讯作者：
Avihingsanon, Anchalee
中科院分区：
文献类型：
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作者：
Chattranukulchai, Pairoj;Thimaporn, Weerayut;Avihingsanon, Anchalee
目的：心血管疾病的患病率随着年龄的增长而增加。亚洲老年艾滋病病毒感染者（PLHIV）超声心动图异常的患病率和危险因素知之甚少。设计图：在泰国进行了一项横断面研究，年龄>50岁的艾滋病毒感染者（N = 298）接受抗逆转录病毒治疗（ART），艾滋病毒阴性对照组（N = 100）的频率与性别和年龄相匹配。研究方法：所有参与者都接受了由训练有素的心脏病专家进行的标准二维经胸超声心动图检查，这些心脏病专家对参与者的护理和HIV状况不知情。Logistic回归分析用于研究心脏异常和危险因素之间的关系。结果：中位年龄为54.7岁（60.8%为男性），37.2%患有高血压，16.6%患有糖尿病。艾滋病毒感染者接受抗逆转录病毒治疗的中位数为16.2年，目前的CD 4细胞计数为每立方毫米616个细胞。超声心动图异常在PLHIV（55%）和对照组（60%）之间没有差异。PLHIV的主要异常如下：左心室（LV）肥大：37%男性和42.2%女性，LV收缩功能障碍（0.7%），舒张功能障碍（24.2%）和肺动脉高压（3.9%）。在PLHIV的多变量分析中，年龄>60岁与舒张功能障碍独立相关，而女性和左心房容积指数>34 mL/m2与肺动脉高压相关（P < 0.05）。ART与任何重大超声心动图异常均无显著相关性。结论：在这个长期、良好抑制、老年的亚洲PLHIV队列中，无症状性LV收缩功能障碍和肺动脉高压的患病率相对较低，而舒张功能障碍和LV肥大则很常见。超声心动图检查结果在艾滋病毒感染者和未感染艾滋病毒的对照组之间没有差异。
Objectives: Prevalence of cardiovascular disease increases with age. Little is known about the prevalence and risk factors for echocardiographic abnormalities among older people living with HIV (PLHIV) from Asia. Design: A cross-sectional study was conducted among PLHIV aged >50 years (N = 298) on antiretroviral treatment (ART) and HIV-negative controls (N = 100) frequency matched by sex and age in Thailand. Methods: All participants underwent standard 2-dimensional transthoracic echocardiography performed by trained cardiologists who were blinded to the participant's care and HIV status. Logistic regression was used to examine the association between cardiac abnormalities and risk factors. Results: The median age was 54.7 years (60.8% men) with 37.2% having hypertension and 16.6% having diabetes mellitus. PLHIV was on ART for a median of 16.2 years with current CD4 cell counts of 616 cells per cubic millimeter. Echocardiogram abnormalities did not differ among PLHIV (55%) and the controls (60%). The major abnormalities in PLHIV were following: left ventricular (LV) hypertrophy: 37% men and 42.2% women, LV systolic dysfunction (0.7%), diastolic dysfunction (24.2%), and pulmonary hypertension (3.9%). From the multivariate analyses in PLHIV, being aged >60 years was independently associated with diastolic dysfunction, whereas female sex and left atrial volume index of >34 mL/m(2) were associated with pulmonary hypertension (P < 0.05). None of the ART was significantly associated with any major echocardiographic abnormalities. Conclusions: In this long-term, well-suppressed, older, Asian PLHIV cohort, the prevalence of asymptomatic LV systolic dysfunction and pulmonary hypertension were relatively low, whereas the diastolic dysfunction and LV hypertrophy were common. Echocardiographic findings did not differ between PLHIV and HIV-uninfected controls.