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Heart fat in HIV: marker or mediator of risk?

Jonathan Buggey1, Chris T Longenecker

  • 1aUniversity Hospitals Cleveland Medical Center, Harrington Heart and Vascular Institute bCase Western Reserve University School of Medicine, Cleveland, Ohio, USA.

Current Opinion in HIV and AIDS
|August 11, 2017
PubMed

Insights

People living with HIV (PLHIV) show increased cardiac fat, linked to higher cardiovascular risk and dysfunction. Monitoring heart fat may guide intensified preventive strategies for these patients.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Imaging

Background:

  • People living with HIV (PLHIV) experience accelerated cardiovascular disease.
  • Ectopic fat deposition, particularly in the heart, is common in PLHIV.
  • Noninvasive imaging reveals higher volumes of epicardial and intracardiac fat in PLHIV.

Purpose of the Study:

  • To review the clinical impact of cardiac fat depots in patients with HIV infection.
  • To summarize current literature on the association between cardiac fat and cardiovascular outcomes in PLHIV.

Main Methods:

  • Literature review of studies investigating cardiac fat in HIV-infected patients.
  • Analysis of noninvasive imaging techniques for quantifying epicardial and intracardiac fat.
  • Examination of associations between cardiac fat volumes, antiretroviral therapy, inflammation, and cardiovascular events.

Main Results:

  • PLHIV exhibit increased epicardial and intracardiac fat volumes, independent of BMI.
  • Higher epicardial fat is linked to coronary artery calcium, myocardial perfusion defects, death, and myocardial infarction.
  • Increased myocardial fat is associated with antiretroviral therapy duration and may cause systolic and diastolic dysfunction.

Conclusions:

  • Cardiac fat in PLHIV serves as a potential imaging marker for cardiovascular risk and may directly contribute to coronary artery disease and dysfunction.
  • While targeted therapies are under investigation, some pharmacotherapies might reduce cardiac fat volumes.
  • Physicians should consider enhanced preventive strategies and monitoring for PLHIV with abnormal cardiac fat detected via noninvasive imaging.
Abstract

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