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[Echocardiographic evaluation of HIV-positive subjects]
G Minardi1, M Di Segni, L Boccardi
1Servizio di Poligrafia, Ospedale San Camillo, Roma.
Insights
Cardiac abnormalities are common in HIV patients, with 75% showing involvement. Echocardiography revealed myocardial dysfunction in 35%, pericardial disease in 37%, and infective endocarditis in 31% of those with human immunodeficiency virus (HIV).
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Imaging
Background:
- Human immunodeficiency virus (HIV) infection can affect multiple organ systems.
- Cardiac complications are increasingly recognized in HIV-infected individuals.
- Understanding the spectrum of cardiac abnormalities is crucial for patient management.
Purpose of the Study:
- To determine the prevalence and types of cardiac abnormalities in patients with HIV infection.
- To characterize echocardiographic findings in a cohort of HIV-positive individuals.
Main Methods:
- Echocardiographic examinations (M-mode, 2D, Doppler) were performed on 51 HIV patients.
- Patient data included demographics, risk factors (intravenous drug use, homosexual activity), and HIV disease stage (AIDS, ARC, asymptomatic).
- Follow-up included mortality assessment and, where available, pathological examination.
Main Results:
- Cardiac abnormalities were detected in 75% of HIV patients.
- Pericardial effusion occurred in 37%, infective endocarditis (valve vegetations) in 31%, and myocardial dysfunction in 35%.
- Myocardial dysfunction included left ventricular dilatation, right ventricular enlargement, biventricular dilatation, and wall motion abnormalities.
Conclusions:
- HIV infection is associated with a high prevalence of cardiac involvement.
- Echocardiography is valuable in identifying diverse cardiac abnormalities in HIV patients.
- These findings underscore the importance of cardiac monitoring in the management of HIV infection.
Abstract:
The purpose of the study was to assess the prevalence and the type of cardiac abnormalities in patients with HIV infection. Echocardiographic examination (M-mode, two-dimensional and Doppler) was performed in 51 patients (40 male, 11 female), whose mean age was 29 +/- 10 years; 48 of them (94%) were intravenous drug addicts, 3 (6%) homosexuals. Diagnosis was AIDS in 19 (37%) patients, AIDS related complex in 19 (37%) and asymptomatic infection in 13 (26%). Echocardiography was normal in 13 subjects. Pericardial effusion was found in 19 patients (in 8 of them, this was the only cardiac abnormality). Valve vegetations were found in 16 patients (3 of them had pericardial effusion, 5 had ventricular dilatation or wall motion abnormalities, 1 had both pericardial and myocardial impairment). Myocardial dysfunction was found in 18 patients: 11 had left ventricular dilatation (5 with wall hypokinesia), 1 had right ventricular enlargement, 1 had biventricular dilatation and 5 had only wall motion abnormalities (diffuse or localized). During the follow-up 9 patients died: 8 had AIDS, 1 was asymptomatic. Eight subjects died during hospitalization (none because of cardiac causes) and one at home for sudden unexplained death. Echocardiography had displayed myocardial dysfunction in 6 of them, thickened pericardium in 1 and was normal in 2. Pathologic examination (performed in 8 subjects) showed cardiac enlargement in 3 subjects, thickened pericardium in 2 and valve vegetation in 1. One subject had histopathologic diagnosis of myocarditis and 7 had non specific histologic abnormalities. The study shows a cardiac involvement in 75% of HIV infected patients: 35% had myocardial dysfunction, 37% pericardial disease, 31% infective endocarditis.(ABSTRACT TRUNCATED AT 250 WORDS)