Ventricular functions in children with human immunodeficiency virus infection after ACE-inhibitors

Area of Science:

• Pediatric Cardiology
• Infectious Diseases
• Cardiovascular Pharmacology

Background:

• Pediatric HIV infection can lead to elevated pulmonary arterial pressure (MPA pressure) and cardiac dysfunction.
• Cardiac abnormalities in pediatric HIV require effective therapeutic interventions.

Purpose of the Study:

• To evaluate the effect of an ACE inhibitor on cardiac function and pulmonary arterial pressure in pediatric HIV patients.
• To assess changes in echocardiographic parameters including ejection fraction (EF), fractional shortening (FS), mean velocity of circumferential fiber shortening (MVCfc), and left ventricular peak systolic wall stress (PS).

Main Methods:

• Prospective evaluation of nine pediatric symptomatic HIV-infected patients.
• Serial echocardiography and Doppler cardiography were performed before and after 12 weeks of ACE inhibitor (Inhibace) administration (0.025 mg/kg/D orally).

Main Results:

• ACE inhibitor treatment significantly improved MVCfc and PS (p < 0.05).
• No significant decrease in MPA pressure was observed.
• Ejection fraction (EF) and fractional shortening (FS) were also assessed.

Conclusions:

• ACE inhibitors show potential in improving cardiac mechanics (MVCfc, PS) in pediatric HIV patients with elevated MPA pressure.
• Long-term studies are needed to determine the efficacy of ACE inhibitors in preventing dilated cardiomyopathy and persistent elevated MPA pressure.