CARDIAC STATUS OF HAART EXPOSED INFANTS OF HIV-INFECTED MOTHERS

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。左室结构和功能的异常与人类免疫缺陷病毒（HIV）有关，也可能与核苷类逆转录酶抑制剂（NRTI）、非核苷类逆转录酶抑制剂（NNRTI）和/或蛋白酶抑制剂（PI）作为高活性抗逆转录病毒治疗（HAART）的一部分使用有关，并导致HIV感染儿童的显著发病率和死亡率。与HIV心肌病相关的左室结构和功能异常可能与HIV引起的收缩力下降、左室扩张、后负荷增加（左室尺寸异常：壁厚）以及心率和血压异常有关。在成人或动物模型中，HAART成分也观察到类似的左室结构和功能异常，可能导致心肌病。由于HAART暴露的血清逆转者没有艾滋病毒，因此更容易了解HAART对心血管的影响。我们发现所提出的左室结构和功能回声参数对于检测线粒体毒性儿童无症状心肌病非常敏感，这是haart相关心脏毒性的机制。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Abnormalities of LV structure and function are associated with the human immunodeficiency virus (HIV), and possibly nucleoside reverse transcriptase inhibitors (NRTI), non-nucleoside reverse transcriptase inhibitors (NNRTI), and/or protease inhibitors (PI) administered as part of highly active antietroviral therapy (HAART), and result in significant morbidity and mortality to HIV infected children. The abnormalities of LV structure and function associated with HIV cardiomyopathy can be related to depressed contractility from HIV, associated with LV dilation, increased afterload (abnormal LV dimension : wall thickness), and abnormalities of heart rate and blood presure. Similar abnormalities of LV structure and function are observed with components of HAART that may lead to cardiomyopathy in adults or animal models. Because HAART-exposed seroreverters do not have HIV it becomes easier to understand the cardiovascular effects of HAART. We have found the proposed echo parameters of LV structure and function are very sensitive for detecting asymptomatic cardiomyopathies in children with mitochondrial toxicity, the proposed mechanism of HAART-associated cardiotoxicity.