HIV, Cocaine & Regional Left Ventricular Dysfunction

描述（由申请人提供）：心力衰竭是美国发病率和死亡率的最重要原因之一。 艾滋病毒和可卡因滥用都可能导致左心室（LV）功能障碍（收缩、舒张或两者兼而有之），可能是由不同的机制引起的。 这些病因尚未得到彻底调查。 发生整体LV功能障碍之前的病理过程通常是局部性的。 虽然HAART提高了HIV患者的生存率，但其对LV功能障碍的影响仍不完全清楚。 这项拟议的研究将招募800名黑人男女，年龄在25-45岁之间，他们没有高血压或冠状动脉疾病的证据，也没有被认为是由于心血管疾病引起的症状：200人将是艾滋病毒（+）和可卡因（+）; 200人艾滋病毒（+）和可卡因（-）; 200人艾滋病毒（-）和可卡因（+）; 200例HIV（-）和可卡因（-）。 将在基线时进行访谈、超声心动图检查、血脂谱、血清细胞因子和其他血液检查。 研究受试者将在2年后重新检查，并随访至少2年。 这项研究的具体目标是：1）估计局部和整体LV功能障碍的患病率和发生率2）研究与局部和整体LV功能障碍发生相关的因素3）研究HAART对局部和整体LV功能障碍发生的影响4）研究HIV感染、可卡因使用风险行为和其他因素的个体和联合影响，包括吸烟、饮酒、血脂、C反应蛋白和细胞因子对黑人男性和女性局部和整体LV功能障碍的影响。 这项研究有可能提供关于HIV、可卡因滥用和HAART对LV功能障碍发展的影响的关键信息。

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.