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Biventricular diastolic function assessed by Doppler echocardiogram in children vertically infected with human
Mauricio L Silva1, Silvia M Nassar2, André P Silva3
1Hospital Infantil Joana de Gusmão, Secretaria de Estado da Saúde de Santa Catarina, Florianópolis, SC, Brazil; Hospital Universitário, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil.
Insights
Cardiac diastolic dysfunction is common in children with human immunodeficiency virus (HIV) infection, affecting both ventricles. This dysfunction, characterized by decreased myocardial compliance in the left and abnormal relaxation in the right, occurs independently of immune status.
Area of Science:
- Cardiology
- Infectious Diseases
- Pediatrics
Background:
- Vertical transmission of human immunodeficiency virus (HIV) can impact cardiovascular health in pediatric patients.
- Asymptomatic and stable pediatric HIV patients require ongoing cardiovascular monitoring.
- Diastolic dysfunction is an early indicator of cardiac compromise.
Purpose of the Study:
- To assess the prevalence of cardiac diastolic dysfunction in asymptomatic pediatric patients with vertically acquired HIV.
- To evaluate biventricular diastolic function using Doppler-echocardiography.
- To explore potential associations between diastolic dysfunction and immune status (CD4+ T-cell count).
Main Methods:
- Observational, prospective, cross-sectional study involving 94 pediatric HIV patients.
- Biventricular diastolic function assessed via Doppler-echocardiography.
- Evaluated hemoglobin, CD4+ T-cell percentage, and weight.
Main Results:
- Diastolic dysfunction identified in 50% of patients.
- Left ventricular dysfunction (decreased myocardial compliance) in 38.7%; right ventricular dysfunction (abnormal relaxation) in 29.4%.
- Simultaneous biventricular dysfunction observed in 14.1%; no correlation with immune status.
Conclusions:
- Cardiac diastolic dysfunction is prevalent in pediatric HIV patients, irrespective of immune status.
- Left ventricular dysfunction predominantly involves decreased myocardial compliance.
- Right ventricular dysfunction primarily presents as abnormal relaxation.
Objective:
to determine, by Doppler-echocardiography, the frequency of cardiac diastolic dysfunction in asymptomatic and clinically stable pediatric patients with vertical infection by the human immunodeficiency virus (HIV), from the cardiovascular viewpoint.
Methods:
this was an observational, prospective, and cross-sectional study, performed at a regional referral clinic for patients with HIV, in a convenience sample of 94 individuals, assessing biventricular diastolic function by Doppler-echocardiography, and weight, blood hemoglobin, and percentage of lymphocytes T-CD4(+).
Results:
fifty patients had diastolic dysfunction. Left ventricular dysfunction occurred in 38.7%, and the predominant type of dysfunction was decreased myocardial compliance. Right ventricular dysfunction was observed in 29.4% of the sample, and abnormal relaxation was the most prevalent type. Simultaneous biventricular dysfunction occurred in 14.1% of the individuals. There was no association between dysfunction and the immune status.
Conclusions:
diastolic dysfunction occurred, individually or simultaneously, with no association with immune status; decreased myocardial compliance was predominant in the left ventricle, and abnormal relaxation in the right ventricle.
