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The Relationship Between Impaired Coronary Endothelial Function and Systemic Markers of Inflammation in People Living

Shashwatee Bagchi1,2, Yaa A Kwapong3, Michael Schär4

  • 1Division of Infectious Diseases, Department of Medicine, University of Maryland School of Medicine, Baltimore MD.

Journal of Acquired Immune Deficiency Syndromes (1999)
|January 12, 2023
PubMed

Insights

Coronary endothelial dysfunction in people with HIV (PWH) is linked to inflammation markers. This suggests a connection between abnormal coronary endothelial function (CEF) and systemic inflammation in PWH, impacting cardiovascular disease risk.

Area of Science:

  • Cardiovascular Disease Research
  • Immunology and Inflammation
  • HIV/AIDS Pathophysiology

Background:

  • People with HIV (PWH) face higher cardiovascular disease (CVD) risk, potentially due to chronic inflammation.
  • Endothelial dysfunction, both systemic (SEF) and coronary (CEF), is an early sign of atherosclerosis and predicts adverse events.
  • The relationship between coronary endothelial function (CEF) and systemic inflammation in PWH remains unclear.

Purpose of the Study:

  • To investigate the association between baseline serum inflammation and adhesion markers and baseline coronary endothelial function (CEF) in PWH.
  • To assess whether baseline inflammation markers predict CEF after 8 weeks in a placebo group.
  • To determine if systemic endothelial function (SEF) is associated with inflammation markers in PWH.

Main Methods:

  • Substudy of a randomized controlled trial involving 82 PWH on antiretroviral therapy.
  • Coronary endothelial function (CEF) assessed noninvasively via MRI measuring coronary blood flow and cross-sectional area changes during handgrip exercise.
  • Systemic endothelial function (SEF) evaluated using brachial ultrasound for flow-mediated dilation; serum markers of inflammation and adhesion were measured.

Main Results:

  • Baseline CEF was associated with interleukin 10 and E-selectin levels.
  • Worse CEF at 8 weeks correlated with higher baseline levels of tumor necrosis factor alpha, intercellular adhesion molecule 1, C-reactive protein, interferon gamma, and sICAM-3.
  • No significant associations were found between SEF and any baseline inflammation or adhesion markers at baseline or 8 weeks.

Conclusions:

  • Coronary endothelial dysfunction, unlike systemic endothelial dysfunction, is significantly associated with specific inflammation and adhesion markers in PWH.
  • CEF, but not SEF, at 8 weeks was linked to baseline inflammation levels.
  • Findings indicate a link between abnormal CEF and systemic inflammation markers in PWH, suggesting potential therapeutic targets for CVD risk reduction.
Abstract

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