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La infección por VIH está asociada con la variabilidad en la repolarización ventricular: el estudio de cohorte de

Amir S Heravi¹, Lacey H Etzkorn², Jacek K Urbanek²

¹School of Medicine (A.S.H.), Johns Hopkins University, Baltimore, MD.

|November 12, 2019

Resumen

Las personas que viven con VIH tienen un mayor riesgo de muerte súbita cardíaca debido a la repolarización cardíaca anormal. Este estudio encontró un mayor índice de variabilidad QT (QTVI) en hombres VIH+, lo que indica una mayor labilidad de repolarización ventricular.

Área de la Ciencia:

Cardiología
Enfermedades infecciosas
Los biomarcadores

Sus antecedentes:

Las personas con el virus de la inmunodeficiencia humana (VIH) enfrentan un mayor riesgo de muerte súbita por arritmia en comparación con las personas no infectadas por el VIH.
La repolarización cardíaca anormal en el VIH puede contribuir a este riesgo elevado.
La labilidad de la repolarización ventricular se investigó como un factor potencial utilizando el índice de variabilidad QT (QTVI).

Objetivo del estudio:

Investigar la asociación entre el estado serológico del VIH y la labilidad de la repolarización ventricular.
Determinar si el índice de variabilidad QT (QTVI) difiere entre individuos VIH positivos y VIH negativos.
Para explorar la influencia de la carga viral del VIH y la inflamación en el QTVI.

Principales métodos:

Se analizó una cohorte de 1123 hombres (589 VIH+ y 534 VIH-) del estudio MACS.
La electrocardiografía ambulatoria utilizando el parche ZioXT proporcionó datos de latido a latido durante varios días.
El QTVI fue calculado y modelado utilizando modelos lineales de efectos mixtos, ajustando los factores demográficos, clínicos e inflamatorios relevantes.

Principales resultados:

Los hombres VIH positivos presentaron un QTVI significativamente mayor en comparación con los hombres VIH negativos, lo que indica una mayor labilidad de repolarización.
Esta asociación fue más pronunciada en hombres VIH+ con carga viral del VIH detectable.
Se observó una menor variabilidad de la frecuencia cardíaca en hombres con VIH, independientemente de la carga viral, lo que sugiere una disfunción autónoma.

Conclusiones:

Los hombres VIH-positivos muestran una mayor variabilidad del intervalo QT (QTVI), particularmente con detección de viremia por VIH y mayor inflamación.
Un QTVI elevado en individuos con VIH+ sugiere una mayor susceptibilidad a las arritmias debido a la labilidad de la repolarización ventricular.
La variabilidad reducida de la frecuencia cardíaca en los hombres VIH+ apunta a una disfunción autónoma subyacente.

Palabras clave:

El SIDA El VIH arritmias cardíacas enfermedades del sistema nervioso autónomo muerte súbita, cardíaca electrocardiografía, de uso ambulatorio inflamación

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