CARDIAC STATUS OF HAART EXPOSED INFANTS OF HIV-INFECTED MOTHERS

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。LV结构和功能的缺失与人类免疫缺陷病毒（HIV）以及作为高效抗病毒治疗（HAART）的一部分给药的核苷逆转录酶抑制剂（NRTI）、非核苷逆转录酶抑制剂（NNRTI）和/或蛋白酶抑制剂（PI）相关，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LV结构和功能异常可能与HIV引起的收缩性降低有关，与LV扩张、后负荷增加（LV尺寸异常：壁厚）以及心率和血压异常相关。在成人或动物模型中，HAART组分也观察到类似的LV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HIV，因此更容易理解HAART的心血管效应。我们发现，所提出的LV结构和功能的回波参数对于检测线粒体毒性儿童的无症状心肌病非常敏感，这是HAART相关心脏毒性的提出机制。

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.