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Cardiac dysfunction in pauci symptomatic human immunodeficiency virus patients: a meta-analysis in the highly active

Enrico Cerrato1, Fabrizio D'Ascenzo, Giuseppe Biondi-Zoccai

  • 1Division of Cardiology, Azienda Ospedaliera Cittá della Salute e della Scienza, Corso Bramante 88-90, 10126 Turin, Italy. enrico.cerrato@gmail.com

European Heart Journal
|January 22, 2013
PubMed

Insights

Cardiac dysfunction is common in human immunodeficiency virus (HIV) patients, even those with few symptoms. This meta-analysis highlights the prevalence of both systolic and diastolic left ventricular dysfunction in HIV-infected individuals.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Human immunodeficiency virus (HIV) infection is linked to cardiac dysfunction, impacting patient morbidity and mortality.
  • Previous studies on HIV and cardiac issues were often conducted before the widespread use of highly active antiretroviral therapy (HAART).

Purpose of the Study:

  • To conduct a comprehensive meta-analysis assessing the incidence of cardiac dysfunction in HIV-infected patients with minimal symptoms.
  • To update the understanding of cardiac dysfunction in the era of HAART.

Main Methods:

  • Systematic screening of Medline, Cochrane Library, and Biomed Central for relevant studies.
  • Pooled analysis of data from 11 studies, including 2242 patients, using random effect methods.
  • Appraisal of baseline treatment and cardiac imaging data.

Main Results:

  • The incidence of left ventricular systolic dysfunction was 8.33% and diastolic dysfunction was 43.38%.
  • Diastolic dysfunction was further categorized into first (31.85%), second (8.53%), and third degree (3.02%).
  • Predictors for systolic dysfunction included high C-reactive protein, smoking, and prior myocardial infarction. Hypertension and older age predicted diastolic dysfunction.

Conclusions:

  • Systolic and diastolic dysfunction are frequent findings in HIV-infected patients with few symptoms.
  • Cardiac dysfunction occurs irrespective of whether patients are on HAART.
Abstract

Keywords:
Antiretroviral therapyEchocardiographyHAARTHIVHeart failure

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