HIV, Cocaine & Regional Left Ventricular Dysfunction

描述（由申请人提供）：心力衰竭是美国最重要的发病和死亡原因之一。HIV和可卡因滥用都可能导致左心室功能障碍（收缩、舒张或两者都有），可能是由不同的机制引起的。这些病因尚未得到彻底调查。在全局左室功能障碍发展之前的病理过程通常是区域性的。虽然HAART提高了HIV患者的生存率，但其对左室功能障碍的影响仍未完全了解。拟议的研究将招募800名年龄在25-45岁之间的黑人男性和女性，他们没有高血压或冠状动脉疾病或被认为是由心血管疾病引起的症状的证据：200名将是艾滋病毒（+）和可卡因（+）；200 HIV（+）和可卡因（-）；200例HIV（-）和可卡因（+）；200个HIV（-）和可卡因（-）。访谈、超声心动图检查、血脂谱、血清细胞因子和其他血液检查将在基线进行。研究对象将在2年后再次接受检查，并至少随访2年。研究的具体目的是：1)估计区域和全球左室功能障碍的患病率和发病率2)调查区域和全球左室功能障碍发展的相关因素3)调查HAART对区域和全球左室功能障碍发展的影响4)调查HIV感染、可卡因使用危险行为和其他因素（包括吸烟、饮酒、血脂）的个体和联合作用。c反应蛋白和细胞因子对黑人男性和女性局部和全局左室功能障碍发展的影响。这项研究有可能为HIV、可卡因滥用和HAART对左室功能障碍发展的影响提供关键信息。

DESCRIPTION (provided by applicant): Heart failure is one of the most important causes of morbidity and mortality in the United States. Both HIV and cocaine abuse can cause left ventricular (LV) dysfunction (systolic, diastolic or both), possibly resulting from separate mechanisms. These etiologies have not been thoroughly investigated. The pathological processes preceding the development of global LV dysfunction are commonly regional in nature. While HAART improves survival in patients with HIV, their impact on LV dysfunction still is not fully understood. The proposed study will enroll 800 black men and women, aged 25-45 years, who have no evidence of hypertension or coronary artery disease or symptoms believed to be due to cardiovascular disease: 200 will be HIV (+) and cocaine (+); 200 HIV (+) and cocaine (-); 200 HIV (-) and cocaine (+); and 200 HIV (-) and cocaine (-). Interviews, echocardiographic examinations, lipid profiles, serum cytokines and other blood tests will be performed at baseline. The study subjects will be re-examined 2 years later and followed up at least 2 years. The specific aims of the study are: 1) to estimate the prevalence and incidence of regional and global LV dysfunction 2) to investigate the factors associated with the development of regional and global LV dysfunction 3) to investigate the impact of HAART on the development of regional and global LV dysfunction 4) to investigate the individual and joint effects of HIV infection, cocaine use risk behaviors, and other factors, including cigarette smoking, alcohol use, lipid profile, and C-reactive protein and cytokines on the development of regional and global LV dysfunction in black men and women. This study has the potential to provide critical information about the impact of HIV, cocaine abuse and HAART on the development of LV dysfunction.