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Pathology of the heart in AIDS. A study of 60 consecutive autopsies

B F Hansen1

  • 1Department of Pathology, Hvidovre Hospital, Denmark.

APMIS : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica
|March 1, 1992
PubMed

Insights

Cardiac pathology is common in AIDS patients, with myocarditis and fibrosis frequently observed. As survival improves, right-sided heart failure is expected to increase in this population.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pathology

Background:

  • Cardiac disease is infrequently reported in patients with Acquired Immunodeficiency Syndrome (AIDS).
  • Previous studies suggest minor cardiac abnormalities in AIDS patients, often detected via echocardiography.
  • Autopsy findings provide crucial insights into the cardiac pathology of AIDS.

Purpose of the Study:

  • To investigate the prevalence and nature of cardiac pathology in a cohort of 60 consecutive autopsies of AIDS patients.
  • To determine the incidence of myocarditis, myocardial fibrosis, and right ventricular abnormalities in AIDS patients.

Main Methods:

  • Examination of cardiac tissue from 60 consecutive autopsies of AIDS patients.
  • Myocarditis assessed using the Dallas criteria.
  • Whole heart examination in the latter 39 cases to evaluate ventricular dilation and hypertrophy.
  • Pathogen identification in cases of myocarditis.

Main Results:

  • Myocarditis was present in 42% (25/60) of cases, with identifiable pathogens in 7 of these.
  • Diffuse myocardial fibrosis was observed in 67% (40/60) of cases, likely resulting from myocyte necrosis and myocarditis.
  • Right ventricular dilation and/or hypertrophy occurred in 38% (15/39) of cases with whole heart examination.

Conclusions:

  • Cardiac pathology, including myocarditis and fibrosis, is highly prevalent in AIDS patients.
  • The observed cardiac changes, particularly right ventricular abnormalities, are linked to pulmonary disease, the primary cause of death in AIDS.
  • Increasing survival times in AIDS patients suggest a rising incidence of right-sided heart failure.

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