Evaluation of Cardiac Findings in People With Human Immunodeficiency Virus

Area of Science:

• Cardiology
• Infectious Diseases
• Medical Imaging

Background:

• Antiretroviral therapy has reduced opportunistic infections and malignancies in people with HIV (PWH).
• However, cardiovascular disease (CVD) prevalence is increasing among PWH.
• Early CVD detection in PWH is crucial for timely intervention.

Purpose of the Study:

• To investigate early cardiovascular disease (CVD) markers in people with HIV (PWH).
• To assess the utility of transthoracic echocardiography (TTE) at rest and during exercise (6-minute walk test [6-MWT]) for CVD detection in PWH.
• To evaluate specific echocardiographic parameters, including interventricular septum (IVS) thickness, posterior wall (PW) thickness, E/e' ratio, and pulmonary pulse transit time (pPTT).

Main Methods:

• A prospective study involving people with HIV (PWH) and healthy controls.
• Transthoracic echocardiography (TTE) performed at rest and immediately after a 6-minute walk test (6-MWT).
• Analysis of demographic data, laboratory results, and echocardiographic parameters including IVS thickness, PW thickness, E/e' ratio, and pPTT.

Main Results:

• PWH exhibited significantly thicker interventricular septum (IVS) and posterior wall (PW) compared to controls.
• Pulmonary pulse transit time (pPTT) was markedly reduced in PWH (127.5 ms vs. 457 ms).
• The E/e' ratio increased significantly after the 6-MWT in PWH. Higher E/e' ratios were observed in PWH with lower CD4+ counts, indicating a correlation between immune status and diastolic dysfunction.

Conclusions:

• Interventricular septum thickness, posterior wall thickness, E/e' ratio, and pPTT are potential early markers for CVD in PWH.
• Changes in diastolic indices, particularly the E/e' ratio, may reflect disease progression and are influenced by CD4+ count.
• pPTT shows promise for assessing pulmonary vascular status and right ventricular function in PWH, warranting further investigation.