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Reversible right ventricular dysfunction in patients with HIV infection.
Umamahesh C Rangasetty1, Atiar M Rahman, Nasir Hussain
1Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX 77555, USA.
Southern Medical Journal
|March 24, 2006
Summary
Human immunodeficiency virus (HIV) can cause isolated right heart failure. Antiretroviral therapy may reverse this cardiomyopathy, improving right ventricular function and size.
Area of Science:
- Cardiology
- Infectious Diseases
- Virology
Background:
- Human immunodeficiency virus (HIV)-related cardiomyopathy typically presents with global left ventricular dysfunction.
- The efficacy of antiretroviral therapy (ART) in reversing HIV cardiomyopathy remains unclear.
- Prognosis for HIV cardiomyopathy is generally poor.
Observation:
- Two patients with HIV infection presented with severe isolated right ventricular (RV) dysfunction.
- These patients had no evidence of pulmonary parenchymal, pulmonary arterial, or left ventricular myocardial involvement.
- Opportunistic infection serologic tests were negative in both cases.
Findings:
- Intensive ART led to progressive and remarkable improvement in right heart failure symptoms.
- Repeat echocardiograms documented normalization of RV size and function.
- RV function improvement correlated with decreased HIV viral load.
Implications:
- HIV can cause isolated right heart cardiomyopathy without left heart or pulmonary involvement.
- Antiretroviral therapy may be effective in reversing HIV-related right heart failure.
- These findings suggest direct HIV infection as a potential cause of isolated RV cardiomyopathy.