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Evaluation of Subtle Left Ventricular Systolic Dysfunction by Longitudinal Systolic Strain in Patients with Human
Sukru Cetin1, Alper Gündüz2, Ayşe Şabablı Çetin2
1Department of Cardiology.
Insights
Global longitudinal strain (GLS) can detect early myocardial dysfunction in human immunodeficiency virus (HIV)-infected patients. Reduced CD4 T-cell counts correlate with this dysfunction, highlighting GLS as a valuable tool for monitoring cardiac health in HIV.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Imaging
Background:
- Left ventricular systolic dysfunction (LVSD) is a significant comorbidity in HIV-infected individuals.
- Conventional echocardiography has limitations in detecting early-stage myocardial dysfunction.
- Global longitudinal strain (GLS) offers improved sensitivity for identifying subclinical cardiac abnormalities.
Purpose of the Study:
- To assess left ventricular systolic function using GLS in HIV-infected patients.
- To investigate the relationship between CD4 T-cell counts and LVSD in this population.
- To determine the utility of GLS in detecting early cardiac changes in HIV.
Main Methods:
- A prospective, case-control study involving 65 HIV-infected patients and 48 healthy controls.
- Both conventional and strain echocardiography were performed.
- CD4 T-cell counts and HIV-RNA levels were measured in HIV-infected participants.
Main Results:
- While baseline characteristics and ejection fraction were similar, significant differences were observed in lipid profiles and cardiac structure between groups.
- Global longitudinal strain (GLS) was significantly reduced in HIV-infected patients compared to controls (p = 0.003).
- A positive correlation was found between GLS and CD4 T-cell counts (r = 0.463, p < 0.001).
Conclusions:
- Reduced CD4 T-cell counts in HIV-infected patients are associated with myocardial dysfunction.
- GLS is a sensitive method for detecting subtle, asymptomatic LVSD in HIV-infected individuals.
- GLS may serve as a valuable biomarker for monitoring cardiac health in HIV management.
Background:
Although left ventricular systolic dysfunction (LVSD) is a major cause of morbidity in human immunodeficiency virus (HIV)-infected patients, there is limited data on cardiac functions of these patients. Compared to the conventional echocardiography, the global longitudinal strain (GLS) can detect subclinical myocardial dysfunction at an earlier stage.
Objectives:
In our study, we aimed to evaluate left ventricular systolic functions using the GLS in HIV-infected patients and to investigate the effect of cluster of differentiation 4 T-cell values on LVSD.
Methods:
This prospective, case-control study included a total of 65 HIV-infected patients and 48 healthy volunteers. Conventional and strain echocardiography were performed on all participants. In HIV-infected patients, CD4 T-cell counts and HIV-ribonucleic acid (HIV-RNA) values were measured.
Results:
The median CD4 T-cell count was 529.65 cells/mm3 in the HIV-infected patients and median duration of living with HIV was 16.25 (range: 2 to 120) months. Baseline characteristics and left ventricular ejection fraction values were similar in both groups. However, there was a significant difference in the low-density lipoprotein cholesterol, triglycerides, interventricular septum, left ventricular posterior wall, and GLS between the groups (p = 0.013, p = 0.005, 0.041, p = 0.013, and p = 0.003, respectively). There was a positive correlation between GLS and CD4 levels (r = 0.463, p < 0.001).
Conclusions:
Our study results suggest that reduced CD4 T-cell counts in HIV-infected patients may cause myocardial dysfunction and GLS can be useful to show subtle LVSD asymptomatic cases.
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