Impaired diastolic function in naïve untreated human immunodeficiency virus infected patients

Abstract

Aim: To evaluate cardiac function and structure in untreated human immunodeficiency virus (HIV) patients without clinical evidence of cardiovascular disease.

Methods: Fifty-three naïve untreated HIV-infected patients and 56 healthy control subjects underwent clinical assessment, electrocardiography (ECG) and echocardiography, including tissue doppler imaging. Moreover, a set of laboratory parameters was obtained from all subjects, including HIV-RNA plasma levels, CD4 cell counts and tumor necrosis factor-α levels.

Results: The two groups showed normal ECG traces and no differences regarding systolic morphologic parameters. In contrast, a higher prevalence of left ventricular diastolic dysfunction (abnormal relaxation or pseudonormal filling pattern) was found in the HIV patients (36% vs 9% in patients and controls, respectively, P <0.001).

Conclusion: Subclinical cardiac abnormalities appear in an early stage of the HIV infection, independent of antiretroviral therapy. The data suggest that HIV per se plays a role in the genesis of diastolic dysfunction.

Keywords: Cardiovascular risk factors; Diastolic function; Human immunodeficiency virus; Naïve subjects.

Figures

Figure 1

Individual E/A and E/Em values in human immunodeficiency virus (HIV) patients according to viral load (r = -0.84). A: E/A values (r = -0.84); B: E/Em values (r = 0.83).

Figure 2

Individual E/A and E/Em ratio values in HIV patients subdivided into two subgroups according to tumor necrosis factor (TNF)-α levels. A: E/A ratio values; B: E/Em ratio values.