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Diffuse-regressive alterations and apoptosis of myocytes: possible causes of myocardial dysfunction in HIV-related

Geanete Pozzan1, Carla Pagliari, Felipe Francisco Tuon

  • 1Pathology Department, Faculty of Medical Sciences, Santa Casa de Sao Paulo, Sao Paulo, Brazil.

International Journal of Cardiology
|January 29, 2008
PubMed

Insights

Cardiac alterations are common in AIDS patients from the pre-highly active antiretroviral therapy era. These changes, including cardiomyocyte apoptosis and TNF alpha, contribute to HIV-related cardiomyopathy development.

Area of Science:

  • Cardiovascular Pathology
  • Infectious Diseases
  • Cell Biology

Background:

  • HIV-related cardiomyopathy is a significant concern in acquired immunodeficiency syndrome (AIDS) patients.
  • Understanding the pathogenesis of cardiac alterations in the pre-highly active antiretroviral therapy (HAART) era is crucial.

Purpose of the Study:

  • To determine the frequency of cardiac alterations in necropsies of AIDS patients from the pre-HAART era.
  • To elucidate the pathogenesis of HIV-related cardiomyopathy.

Main Methods:

  • Retrospective analysis of 94 complete necropsies from AIDS patients.
  • Macroscopic, histopathologic, and ultrastructural myocardial evaluations were performed.
  • Techniques included histochemistry, immunohistochemistry, and in situ hybridization.

Main Results:

  • Cardiac alterations were observed in 94.4% of cases.
  • Biventricular dilation was present in 74%, with diffuse regressive changes in cardiomyocytes.
  • Ultrastructural findings revealed cardiomyocyte apoptosis and activated capillary-endothelial cells, with tumor necrosis factor alpha (TNF alpha) detected in most cases.

Conclusions:

  • Histopathological and ultrastructural findings are associated with cardiac chamber dilation, suggesting a spectrum of alterations leading to HIV-related cardiomyopathy.
  • Cardiomyocyte apoptosis and TNF alpha suggest a role for this cytokine in myocardial dysfunction and apoptosis in HIV infection.
Abstract

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