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Relationships among HIV infection, metabolic risk factors, and left ventricular structure and function

William Todd Cade1, Edgar Turner Overton, Kristin Mondy

  • 1Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO 63108, USA. tcade@wustl.edu

AIDS Research and Human Retroviruses
|April 12, 2013
PubMed

Insights

Metabolic complications (MC) significantly impair left ventricular (LV) diastolic function in individuals with and without HIV. While HIV independently affects systolic function, MC poses the primary risk for diastolic dysfunction.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Metabolic Disorders

Background:

  • Metabolic complications (MC) are increasingly recognized as a risk factor for cardiovascular disease.
  • Left ventricular (LV) dysfunction is a known complication in individuals with HIV.
  • The combined impact of MC and HIV on LV function requires further investigation.

Purpose of the Study:

  • To investigate whether metabolic complications (MC) confer an additional risk for left ventricular (LV) dysfunction in people living with HIV (HIV+).
  • To compare LV function between HIV+ and HIV- individuals with and without MC.

Main Methods:

  • Cross-sectional study involving HIV+ and HIV- men and women categorized by MC status.
  • Four participant groups: HIV+/MC+, HIV+/MC-, HIV-/MC+, HIV-/MC-.
  • Comprehensive echocardiography including 2-D, Doppler, and tissue Doppler assessments.

Main Results:

  • Higher prevalence of systolic dysfunction and LV hypertrophy in HIV+ participants compared to HIV-.
  • Participants with MC showed a greater prevalence of LV hypertrophy.
  • Reduced early mitral annular velocity during diastole in groups with MC, indicating impaired diastolic function.
  • No additive negative effect of HIV on diastolic function beyond MC; HIV independently associated with lower systolic function.

Conclusions:

  • Metabolic complications significantly impair LV diastolic function irrespective of HIV status.
  • HIV infection is independently associated with reduced LV systolic function.
  • Clinical monitoring of LV function is crucial for individuals with metabolic risk factors, regardless of HIV status.

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