Exploring the PREVENT HF score and myocardial function among persons with HIV

Area of Science:

• Cardiology
• Infectious Diseases
• Medical Imaging

Background:

• People with HIV (PWH) are at increased risk for myocardial structural changes, potentially leading to heart failure with preserved ejection fraction (HFpEF).
• Early detection of subclinical myocardial dysfunction is crucial for managing cardiovascular disease (CVD) risk in PWH.
• The AHA PREVENT HF risk score is a tool for predicting cardiovascular events, but its utility in PWH with subclinical disease requires investigation.

Purpose of the Study:

• To explore the association between the AHA PREVENT HF risk score and cardiac magnetic resonance (CMR) imaging findings in people with HIV (PWH).
• To assess the correlation of the PREVENT HF score with indicators of subclinical myocardial dysfunction and inflammation in PWH.

Main Methods:

• A cross-sectional study involving 37 PWH on antiretroviral therapy (ART), aged 40-65, without known CVD.
• Participants underwent cardiac magnetic resonance (CMR) imaging.
• The AHA PREVENT HF risk score was calculated and correlated with CMR-derived measures including left atrial volume index (LAVI), global longitudinal strain (GLS), left ventricular mass index (LVMI), extracellular volume (ECV), and T1 relaxation time.

Main Results:

• The PREVENT HF score showed significant correlations with LAVI (ρ=0.35, P=0.04), T1 relaxation time (ρ=0.35, P=0.04), interleukin-6 (IL-6) (ρ=0.36, P=0.03), and NT-proBNP (ρ=0.42, P=0.01).
• Higher risk scores were observed in individuals meeting clinical cutoffs for LAVI (>34 ml/m²) and T1 relaxation time (≥1250 ms).
• Optimal cutoffs for the PREVENT HF score were identified for predicting elevated LAVI (2.5, AUROC 0.769) and T1 relaxation time (3.6, AUROC 0.727).

Conclusions:

• The AHA PREVENT HF score is associated with indicators of altered myocardial structure and inflammation in asymptomatic PWH with subclinical disease.
• These findings suggest the potential utility of the PREVENT HF score in assessing radiographic findings related to cardiac health in PWH.
• Further research is needed to validate the PREVENT HF score as a predictive tool for cardiovascular outcomes in the PWH population.