May 18, 2015
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HIV patients without CVD still have decreased myocardial function

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HIV-infected adults without known cardiovascular disease appeared to have decreased myocardial function, according to recent findings.

“The etiology of impaired myocardial function in HIV is not yet fully understood, but studies have implicated traditional risk factors such as age, hypertension and smoking as well as antiretroviral therapy and direct effects of HIV,” researchers wrote in The Journal of Infectious Diseases.

In a cross-sectional study, Colleen Hadigan, MD, MPH, of the National Institute of Allergy and Infectious Diseases, and colleagues recruited 95 HIV-infected patients and 30 age-, gender- and race-matched adults without known CVD between April 2010 and May 2013. The researchers used MRI to assess whether intramyocardial lipid and fibrosis were possible factors in HIV-associated myocardial dysfunction.

They found that HIV patients had significantly decreased systolic function (radial strain, 21.7% ± 8.6%) vs. controls (30.5% ± 14.2%; P = .004). HIV patients also had increased intramyocardial lipid and fibrosis compared with patients without HIV (P ≤ .04 for both), and these measures were proportional to the extent of myocardial dysfunction as measured by strain parameters. Duration of ARV and visceral fat were positively associated to intramyocardial lipid, according to the researchers. Moreover, there was a strong correlation between diminished myocardial function and increased monocyte chemoattractant protein-1 levels (r = 0.396; P = .0002) and lipopolysaccharide binding protein (r = 0.25; P = .02).

“Our study identified increased subclinical cardiac dysfunction in association with cardiac steatosis and fibrosis in HIV-infected adults,” the researchers wrote. “Given the known increased risk of cardiovascular disease in persons living with HIV, it is important to identify risk factors and create targeted strategies to prevent progression of global cardiac dysfunction.” – by Jen Byrne

Disclosure: The researchers report no relevant financial disclosures.