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Assessment of ventricular diastolic function in AIDS patients from Congo: a Doppler echocardiographic study
B Longo-Mbenza1, L V Seghers, E K Vita
1Heart of Africa Cardiovascular Centre, Lomo Medical, Kinshasa/Limete, Congo.
Insights
Left ventricular diastolic dysfunction is common in human immunodeficiency virus (HIV) patients, even without symptoms. Echocardiography effectively detects these cardiac abnormalities in HIV-infected individuals.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Imaging
Background:
- Human immunodeficiency virus (HIV) infection can affect cardiac function.
- Left ventricular dysfunction is a potential complication in HIV patients.
- The prevalence and presentation of cardiac issues in African HIV patients require investigation.
Purpose of the Study:
- To determine the prevalence of left ventricular dysfunction in African patients with HIV.
- To test the hypothesis that HIV-infected patients with left ventricular dysfunction are asymptomatic.
- To assess the utility of echocardiography in detecting cardiac abnormalities in this population.
Main Methods:
- M-mode, cross-sectional, and Doppler echocardiography were performed.
- 49 consecutive HIV-infected patients (30 HIV+ carriers, 19 AIDS patients) were studied.
- 58 controls without cardiovascular history were included for comparison.
Main Results:
- 42 of 49 HIV-infected patients exhibited left ventricular diastolic dysfunction.
- Diastolic dysfunction was more pronounced in AIDS patients than in HIV+ carriers.
- Systolic function remained normal in all HIV-infected patients; echocardiography revealed unsuspected cardiac lesions.
Conclusions:
- Echocardiography is valuable for detecting subclinical left ventricular diastolic dysfunction in HIV patients.
- HIV-infected patients can have significant cardiac abnormalities without apparent symptoms.
- Despite diastolic dysfunction, systolic function was preserved in the studied cohort.
Objective:
To investigate the prevalence of left ventricular dysfunction in African patients infected with the human immunodeficiency virus (HIV). The hypothesis was that HIV infected patients with left ventricular dysfunction are asymptomatic.
Methods:
M mode, cross sectional, and Doppler echocardiography were performed in 49 consecutive patients (30 HIV positive (HIV+) carriers and 19 AIDS patients). None of the patients or 58 controls had a medical history of cardiovascular abnormalities.
Results:
Cardiac abnormalities were not suspected on physical, electrocardiographic, and radiological examination. Forty-two of the HIV infected patients had left ventricular diastolic dysfunction; this was more pronounced in AIDS patients than in HIV+ carriers. Systolic function was normal in both stages of HIV infection. Left ventricular isovolumic relaxation time (mean SD)) increased from 87.2 (12.4) ms in the carrier state to 103.9 (19.3) ms in AIDS (p < 0.05, Bonferoni correction), peak early filling velocity declined from 0.54 (0.1) to 0.44 (0.1) m/s (p < 0.05), and late velocity increased from 0.64 (0.1) to 0.69 (0.2) m/s. A restrictive filling pattern was explained by concentric hypertrophy in 23 HIV infected patients, and by systemic amyloidosis with left ventricular dilatation in 12 of 49 HIV infected patients.
Conclusions:
Echocardiography is a useful technique for detecting left ventricular diastolic dysfunction in HIV infected patients with clinically unsuspected cardiac lesions. Systolic function was normal despite the presence of such cardiac abnormalities.