Multiple substance use, inflammation and cardiac stretch in women living with HIV.
Multiple substance use, inflammation and cardiac stretch in women living with HIV.
复制标题
艾滋病毒妇女的多种物质使用，炎症和心脏拉伸。
DOI：
10.1016/j.drugalcdep.2022.109564
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发表时间：
2022-09-01
影响因子：
4.2
通讯作者：
Hunt, Peter W.
中科院分区：
文献类型：
--
作者：
Riley, Elise D.;Kizer, Jorge R.;Tien, Phyllis C.;Vittinghoff, Eric;Lynch, Kara L.;Wu, Alan H. B.;Coffin, Phillip O.;Beck-Engeser, Gabriele;Braun, Carl;Hunt, Peter W.
在艾滋病毒携带者中，心血管疾病(CVD)和心力衰竭(HF)的发病率高得不成比例，而且存在性别差异。与心血管疾病相关的研究很少集中在药物使用上，但它在低收入艾滋病毒携带者(WLWH)患者中很常见，并增加了心脏功能障碍。我们从旧金山社区招募了无庇护和住房不稳定的WLWH，参与了一项为期六个月的队列研究，调查药物使用、炎症和心脏功能障碍之间的联系。调整了心血管疾病危险因素、合并感染、药物和更年期，我们检查了毒理学确认的药物使用和炎症(C-反应蛋白，sCD14，sCD163和sTNFR2)对NT-proBNP水平的影响，NT-proBNP是心脏拉伸和心力衰竭的生物标志物。在74名WLWH中，中位年龄为53岁，其中45%是黑人。基线时，72%的参与者患有高血压。使用的物质包括烟草(65%)、大麻(53%)、可卡因(49%)、甲基苯丙胺(31%)、酒精(28%)和阿片类药物(20%)。与NT-proBNP显著相关的因素包括大麻的使用(调整后相对效应[ARE]：−39.6%)和sTNFR2(ARE：65.5%)。对心力衰竭进行调整，并将分析限制在病毒抑制的人身上，并没有显著降低影响。大麻使用与sTNFR2没有显著关联，也没有改变sTNFR2和NT-proBNP之间的关联。在使用多物质的WLWH中，发出心脏伸展信号的NT-proBNP水平与sTNFR2正相关，但在使用大麻的人中低40%。结果是否表明，在使用多种物质的WLWH患者中，与大麻使用相关的心血管通路是否独立于炎症减轻心脏应激和功能障碍，值得进一步研究。
Cardiovascular disease (CVD) and heart failure (HF) are disproportionately high in people living with HIV and differ by sex. Few CVD-related studies focus on drug use, yet it is common in low-income women living with HIV (WLWH) and increases cardiac dysfunction. We recruited unsheltered and unstably housed WLWH from San Francisco community venues to participate in a six-month cohort study investigating linkages between drug use, inflammation, and cardiac dysfunction. Adjusting for CVD risk factors, co-infections, medications, and menopause, we examined the effects of toxicology-confirmed drug use and inflammation (C-reactive protein, sCD14, sCD163 and sTNFR2) on levels of NT-proBNP, a biomarker of cardiac stretch and HF. Among 74 WLWH, the median age was 53 years and 45% were Black. At baseline, 72% of participants had hypertension. Substances used included tobacco (65%), cannabis (53%), cocaine (49%), methamphetamine (31%), alcohol (28%), and opioids (20%). Factors significantly associated with NT-proBNP included cannabis use (Adjusted Relative Effect [ARE]: −39.6%) and sTNFR2 (ARE: 65.5%). Adjusting for heart failure and restricting analyses to virally suppressed persons did not diminish effects appreciably. Cannabis use was not significantly associated with sTNFR2 and did not change the association between sTNFR2 and NT-proBNP. Among polysubstance-using WLWH, NT-proBNP levels signaling cardiac stretch were positively associated with sTNFR2, but 40% lower in people who used cannabis. Whether results suggest that cardiovascular pathways associated with cannabis use mitigate cardiac stress and dysfunction independent of inflammation in WLWH who use multiple substances merits further investigation.
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DOI：
10.1161/circheartfailure.120.007264
发表时间：
2020-08
期刊：
Circulation. Heart failure
影响因子：
--
作者：
Nayak A;Hicks AJ;Morris AA
通讯作者：
Morris AA
DOI：
10.14740/jocmr3154w
发表时间：
2017-11
期刊：
Journal of clinical medicine research
影响因子：
--
作者：
Gilotra TS;Geraci SA
通讯作者：
Geraci SA
DOI：
10.1016/s0140-6736(08)61113-7
发表时间：
2008-07-26
期刊：
Lancet (London, England)
影响因子：
--
作者：
Antiretroviral Therapy Cohort Collaboration
通讯作者：
Antiretroviral Therapy Cohort Collaboration
影响因子：
2.8
作者：
Manzano-Fernandez, Sergio;Boronat-Garcia, Miguel;Andres Pascual-Figal, Domingo
通讯作者：
Andres Pascual-Figal, Domingo
DOI：
10.1111/j.1440-1681.2008.04894.x
发表时间：
2008-04-01
影响因子：
2.9
作者：
Campbell, Duncan J.
通讯作者：
Campbell, Duncan J.