Myocardial dysfunction in human immunodeficiency virus infection: an echocardiographic study

Area of Science:

• Cardiology
• Infectious Diseases
• Human Immunodeficiency Virus (HIV) Research

Background:

• Cardiac involvement is a significant concern in patients with Human Immunodeficiency Virus (HIV) infection.
• Understanding the prevalence and nature of cardiac manifestations is crucial for patient management.
• Opportunistic infections and declining CD4 cell counts are known to impact various organ systems, including the heart.

Purpose of the Study:

• To ascertain the frequency and specific characteristics of myocardial dysfunction in HIV-infected individuals.
• To identify other cardiac abnormalities present in the human immunodeficiency virus population.
• To correlate echocardiographic findings with CD4 cell counts and opportunistic infections.

Main Methods:

• A cohort of 52 patients diagnosed with HIV infection underwent comprehensive screening.
• Detailed medical history, including opportunistic infections, was recorded.
• Two-dimensional echocardiography was performed to assess cardiac structure and function, alongside CD4 cell count determination.

Main Results:

• Echocardiographic abnormalities were detected in 42.3% (22 out of 52) of the patients.
• Common findings included reduced fractional shortening (34.6%), left ventricular diastolic dysfunction (19.2%), global hypokinesia (15.4%), and pericardial effusion (11.5%).
• A higher prevalence of echocardiographic abnormalities was observed in patients with CD4 counts below 100 cells/mm³ and those with opportunistic infections (e.g., TB, candidiasis, pneumonias).

Conclusions:

• Cardiac involvement, including pericardial effusion, diastolic dysfunction, reduced fractional shortening, and global hypokinesia, is prevalent in HIV patients, often without clear clinical symptoms.
• These echocardiographic findings are significantly associated with opportunistic infections and low CD4 cell counts.
• Routine echocardiographic screening may be beneficial for early detection and management of cardiac complications in HIV-infected individuals.