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Left ventricular systolic function in Nigerian children with human immunodeficiency virus infection
Olukemi Omowumi Ige1, Stephen Oguche, Fidelia Bode-Thomas
1Department of Paediatrics, Jos University Teaching Hospital, Jos, Nigeria. kemidr@hotmail.com
Insights
Left ventricular systolic dysfunction is common in HIV-infected children, affecting 50% of cases. This dysfunction worsens with age and requires regular monitoring in pediatric HIV patients.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Cardiovascular Health
Background:
- Human immunodeficiency virus (HIV) infection can impact various organ systems in children, including the cardiovascular system.
- Left ventricular (LV) systolic function is a critical indicator of cardiac health.
- Understanding the prevalence and risk factors for LV systolic dysfunction in pediatric HIV is crucial for timely intervention.
Purpose of the Study:
- To compare left ventricular (LV) systolic function between HIV-infected children and healthy controls.
- To determine the prevalence of LV systolic dysfunction in HIV-infected children.
- To investigate the association of LV systolic dysfunction with age, disease stage, and zidovudine use.
Main Methods:
- A comparative cross-sectional descriptive study was conducted.
- One hundred fifty HIV-infected children (aged 6 weeks-14 years) and 150 age- and sex-matched healthy controls were enrolled.
- Left ventricular dimensions, fractional shortening (FS), and ejection fraction (EF) were measured. LV systolic dysfunction was defined as FS <28% or EF <50%.
Main Results:
- HIV-infected children exhibited significantly larger LV dimensions in systole compared to controls (P < .001).
- Mean LV fractional shortening (FS) and ejection fraction (EF) were significantly reduced in HIV-infected children (P < .001).
- Left ventricular systolic dysfunction was detected in 50% of HIV-infected children versus 3.3% of controls (P < .001). Dysfunction was associated with older age but not disease stage or zidovudine use.
Conclusions:
- Left ventricular systolic dysfunction is significantly more prevalent in HIV-infected children than in healthy controls.
- LV systolic function deteriorates with increasing age in children with HIV.
- Serial evaluation of left ventricular systolic function is recommended for HIV-infected children.
Objective:
The objective of this article was to compare the left ventricular (LV) systolic function of human immunodeficiency virus (HIV)-infected children with that of healthy controls, determine the prevalence of LV systolic dysfunction in HIV-infected children, and its association with age, stage of disease, and use of zidovudine.
Study Design:
This was a comparative cross-sectional descriptive study.
Setting:
A University Teaching Hospital in North-Central Nigeria in 2008.
Patients:
One hundred fifty HIV-infected children aged 6 weeks-14 years, and an equal number of age- and sex-matched apparently healthy controls.
Outcome Measures:
Left ventricular internal dimensions in diastole and systole, LV fractional shortening (FS) and ejection fraction (EF). Left ventricular systolic dysfunction was considered present when FS was <28% or EF was <50%.
Results:
Mean LV internal dimensions in diastole was similar in subjects and controls (P= .26). Left ventricular internal dimensions in systole was significantly larger in subjects (2.7 cm, 95% confidence interval [CI] 2.6-2.8 cm) than controls (2.4 cm, 95% CI 2.3-2.5 cm) (P < .001). Mean FS of 27.8% (26.8-28.8%) in subjects was significantly reduced compared with 33.7% (33.1-34.3%) in controls (P < .001), as was EF 61.5% (60.7-62.3%) in subjects and 70.5% (69.7-71.3%) in controls (P < .001). Left ventricular systolic dysfunction was detected in 75 (50.0%, 95% CI 41.7-58.3%) subjects and 5 (3.3%, 95% CI 2.2-6.7) controls (P < .001). Subjects with left ventricular systolic dysfunction were significantly older than those without (P < .001) but did not differ significantly from them with respect to zidovudine therapy or stage of disease.
Conclusions:
Left ventricular systolic dysfunction is significantly more frequent in HIV-infected children compared with controls. Left ventricular systolic function in HIV-infected children deteriorates with increasing age and should be serially evaluated in them.
