Nearly half of HIV patients with dyspnea had echocardiographic evidence of structural heart disease, according to findings presented at EuroEcho-Imaging 2013.
Researchers performed a prospective cohort study of 65 patients with HIV (63% men; mean age, 48 years) who had at least grade II dyspnea on the NYHA scale. They aimed to determine whether HIV stage or detectable blood viral load correlates with the degree of heart disease.
Nieves Montoro-Lopez, MD, of La Paz University Hospital in Madrid, and colleagues used viral blood load and CD4 count to determine HIV stage and performed a transthoracic ECG on all participants to assess ventricular hypertrophy, systolic and diastolic dysfunction, and pulmonary hypertension. They also assessed the following CV risk factors for each patient: hypertension, diabetes, smoking status, dyslipidemia and renal failure.
The researchers found that 46.7% of participants had some sign of structural heart disease, most commonly cardiomyopathy. They found no correlation between having AIDS and the degree of heart disease.
However, they found that those with positive blood viral load had a higher incidence of structural heart disease compared with those who had an undetectable viral load (75% vs. 43%; P<.04), and that this was true regardless of CV risk profile, type of antiretroviral therapy, sex or age.
“Detectable viral load in blood doubles the prevalence of heart disease, so that HIV itself may be an independent causal agent,” Montoro-Lopez and colleagues wrote in the presentation abstract. “These data should be taken into account in the screening of structural heart disease in these patients.”
In a press release, Montoro-Lopez said: “These findings open the door to the hypothesis that HIV is involved in the etiology of cardiac damage. It is known that HIV can produce a pro-inflammatory response, and this could involve the heart, too. We are conducting further studies to test this idea.”
For more information:
Montoro-Lopez M. Abstract P119. Presented at: EuroEcho-Imaging 2013; Dec. 11-14, 2013; Istanbul.
Disclosure: Montoro-Lopez reports no relevant financial disclosures.