Immune Correlates of Diffuse Myocardial Fibrosis and Diastolic Dysfunction Among Aging Women With Human Immunodeficiency Virus

Abstract

Human immunodeficiency virus (HIV) imparts increased heart failure risk to women. Among women with HIV (WHIV), immune pathways relating to heart failure precursors may intimate targets for heart failure prevention strategies. Twenty asymptomatic, antiretroviral-treated WHIV and 14 non-HIV-infected women matched on age and body mass index underwent cardiac magnetic resonance imaging and immune phenotyping. WHIV (vs non-HIV-infected women) exhibited increased myocardial fibrosis (extracellular volume fraction, 0.34 ± 0.06 vs 0.29 ± 0.04; P = .002), reduced diastolic function (diastolic strain rate, 1.10 ± 0.23 s-1 vs 1.39 ± 0.27 s-1; P = .003), and heightened systemic monocyte activation. Among WHIV, soluble CD163 levels correlated with myocardial fibrosis (r = 0.53; P = .02), while circulating inflammatory CD14+CD16+ monocyte CCR2 expression related directly to myocardial fibrosis (r = 0.48; P = .04) and inversely to diastolic function (r = -0.49; P = .03). Clinical Trials Registration. NCT02874703.

Keywords: HIV; diastolic dysfunction; inflammation; myocardial fibrosis; women.

© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Figures

Figure 1.

Diffuse myocardial fibrosis and diastolic function among women with human immunodeficiency virus (WHIV) and women without human immunodeficiency virus (HIV). A, Diffuse myocardial fibrosis, as quantified by the cardiac magnetic resonance imaging (MRI) measure of extracellular volume fraction, was increased among WHIV (n = 19; extracellular volume fraction uninterpretable for 1 participant) compared with non-HIV-infected women (n = 14) (P = .002 by t test). B, Diastolic function, as quantified by the cardiac MRI measure of circumferential diastolic strain rate, was reduced among WHIV (n = 20) compared with non-HIV-infected women (n = 14) (P = .003 by t test). In both graphs, data are presented as box plots, where the box represents the median and interquartile range and the whiskers represent the minimum and maximum values.