Related Experiment Video
Updated: May 1, 2026
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Evaluation of human immunodeficiency virus infection-related left ventricular systolic dysfunction by tissue Doppler
Imran Onur1, Baris Ikitimur, Fahrettin Oz
1Department of Cardiology, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey.
Insights
Human immunodeficiency virus (HIV) patients on HAART may have subtle left ventricular (LV) systolic dysfunction. Echocardiographic strain imaging can detect this early subclinical myocardial dysfunction.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Imaging
Background:
- Cardiovascular complications are a major cause of morbidity and mortality in human immunodeficiency virus (HIV) patients.
- Highly active antiretroviral treatment (HAART) has altered the cardiovascular profile of HIV patients, with subclinical left ventricular (LV) dysfunction becoming more apparent.
- Conventional echocardiography may not detect early-stage myocardial dysfunction, necessitating advanced imaging techniques.
Purpose of the Study:
- To evaluate tissue Doppler-derived LV strain and strain rate (SR) in asymptomatic, stable adult HIV patients on HAART.
- To compare LV function parameters, including strain imaging, between HIV patients and healthy controls.
- To determine if echocardiographic strain imaging can detect subclinical LV dysfunction in HIV patients.
Main Methods:
- A transthoracic echocardiography study involving 21 asymptomatic HIV patients on HAART and 27 healthy volunteers.
- Measurement of traditional LV function parameters, including LV ejection fraction (LVEF).
- Assessment of tissue velocity imaging (TVI) and tissue Doppler strain imaging (SI) parameters for LV strain and strain rate (SR).
Main Results:
- HIV patients had a lower mean LVEF compared to controls, although still within normal limits (64.5% ± 10.2% vs. 72.2% ± 6.4%, P = 0.003).
- No significant differences were found in other traditional echocardiographic measures or TVI parameters between the groups.
- LV systolic strain and SR parameters were impaired in HIV patients, indicating subtle LV systolic dysfunction, while diastolic function remained comparable.
Conclusions:
- Left ventricular systolic strain parameters are sensitive indicators of subclinical LV systolic dysfunction in asymptomatic HIV patients.
- Strain imaging may offer an earlier detection method for myocardial dysfunction in HIV patients compared to conventional echocardiography.
- These findings highlight the utility of strain imaging in monitoring cardiovascular health in HIV-infected individuals.
Objective:
Cardiovascular involvement causes significant morbidity and mortality among patients with human immunodeficiency virus (HIV) infection. Since the introduction of highly active antiretroviral treatment (HAART), subtle changes in left ventricular (LV) function, which may be clinically silent, have become more pronounced in HIV patients. Echocardiographic strain imaging (SI) may detect subclinical myocardial dysfunction at an earlier stage compared with conventional echocardiography. The aim of this study was to evaluate tissue Doppler-derived LV strain and strain rate (SR) along with conventional measures of LV function in asymptomatic, stable adult HIV patients on HAART.
Methods:
Twenty-one patients with HIV infection (mean age: 37.8 ± 11.9 years, 11 males) who had no cardiovascular complaints and 27 healthy volunteers (mean age: 40.9 ± 5.8 years, 14 males) were enrolled. Traditional parameters including LV ejection fraction (EF) were measured along with tissue velocity imaging (TVI) and tissue Doppler SI parameters using transthoracic echocardiography.
Results:
The mean duration of HIV infection was 30.8 ± 25.1 (3-120) months. The mean LVEF in HIV group was within normal limits but lower than controls (64.5% ± 10.2% vs. 72.2% ± 6.4%, P = 0.003). There were no differences in other major traditional measures, as well as TVI parameters between groups. LV systolic strain and SR parameters were impaired indicating subtle LV systolic dysfunction in HIV group. No difference in diastolic function was observed between groups.
Conclusion:
Left ventricular systolic strain parameters may be utilized to demonstrate subtle LV systolic dysfunction in asymptomatic HIV patients.
Related Concept Videos
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:17Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...