Cardiac dysfunction in patients seropositive for the human immunodeficiency virus.

Area of Science:

• Cardiology
• Infectious Diseases
• Immunology

Background:

• Cardiac dysfunction is a concern in patients with human immunodeficiency virus (HIV).
• Symptoms like dyspnea on exertion or reduced anaerobic threshold may indicate cardiac involvement.
• Early detection is crucial for managing HIV-associated cardiovascular complications.

Purpose of the Study:

• To investigate the presence and extent of cardiac dysfunction in HIV-seropositive patients.
• To assess cardiac function in individuals with symptoms suggestive of heart problems.
• To determine if cardiac disease occurs irrespective of the immunologic stage in HIV infection.

Main Methods:

• Exercise right-sided heart catheterization was performed on 9 HIV-seropositive patients without a history of opportunistic infections.
• Hemodynamic parameters during exercise were compared to those of 13 healthy control subjects.
• Blood CD4 lymphocyte counts were analyzed, and endomyocardial biopsy was performed in one case.

Main Results:

• HIV-positive patients exhibited significantly elevated exercise pulmonary capillary wedge pressure and right atrial pressure compared to controls.
• Eight out of nine patients had at least one abnormal catheterization value, with four showing multiple abnormalities.
• CD4 counts were generally preserved (>=0.2 x 10(9)/L) in most patients, and one showed biopsy-confirmed cardiomyopathy.

Conclusions:

• Cardiac disease can manifest at any stage of human immunodeficiency virus infection.
• These findings suggest a direct or indirect effect of HIV on cardiac function.
• The study highlights the importance of monitoring cardiac health in all HIV-positive individuals.