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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Comprehensive cardiac magnetic resonance imaging and spectroscopy reveal a high burden of myocardial disease in HIV patients
Circulation, Volume 128, No. 8, Year 2013
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Description
BACKGROUND - : HIV infection continues to be endemic worldwide. Although treatments are successful, it remains controversial whether patients receiving optimal therapy have structural, functional, or biochemical cardiac abnormalities that may underlie their increased cardiac morbidity and mortality. The purpose of this study was to characterize myocardial abnormalities in a contemporary group of HIV-infected individuals undergoing combination antiretroviral therapy. METHODS AND RESULTS - : Volunteers with HIV who were undergoing combination antiretroviral therapy and age-matched control subjects without a history of cardiovascular disease underwent cardiac magnetic resonance imaging and spectroscopy for the determination of cardiac function, myocardial fibrosis, and myocardial lipid content. A total of 129 participants were included in this analysis. Compared with age-matched control subjects (n=39; 30.23%), HIV-infected subjects undergoing combination antiretroviral therapy (n=90; 69.77%) had 47% higher median myocardial lipid levels (P <0.003) and 74% higher median plasma triglyceride levels (both P<0.001). Myocardial fibrosis, predominantly in the basal inferolateral wall of the left ventricle, was observed in 76% of HIV-infected subjects compared with 13% of control subjects (P<0.001). Peak myocardial systolic and diastolic longitudinal strain were also lower in HIV-infected individuals than in control subjects and remained statistically significant after adjustment for available confounders. CONCLUSIONS - : Comprehensive cardiac imaging revealed cardiac steatosis, alterations in cardiac function, and a high prevalence of myocardial fibrosis in a contemporary group of asymptomatic HIV-infected subjects undergoing combination antiretroviral therapy. Cardiac steatosis and fibrosis may underlie cardiac dysfunction and increased cardiovascular morbidity and mortality in subjects with HIV. © 2013 American Heart Association, Inc.
Authors & Co-Authors
Holloway, Cameron J.
United Kingdom, Oxford
John Radcliffe Hospital
Australia, Sydney
St. Vincent's Hospital Sydney
Ntusi, Ntobeko A.B.
United Kingdom, Oxford
John Radcliffe Hospital
Mahmod, Masliza
United Kingdom, Oxford
John Radcliffe Hospital
Wainwright, Emma
United Kingdom, Oxford
Nihr Oxford Biomedical Research Centre
Clutton, Genevieve T.
United Kingdom, Oxford
Nihr Oxford Biomedical Research Centre
Hancock, Gemma
United Kingdom, Oxford
Nihr Oxford Biomedical Research Centre
Piechnik, Stefan Kazimierz
United Kingdom, Oxford
Nihr Oxford Biomedical Research Centre
United Kingdom, Oxford
John Radcliffe Hospital
Schneider, Jürgen E. Ernst
United Kingdom, Oxford
John Radcliffe Hospital
Angus, Brian John
United Kingdom, Oxford
Nihr Oxford Biomedical Research Centre
Clarke, Kieran J.
Unknown Affiliation
Dorrell, Lucy
United Kingdom, Oxford
Nihr Oxford Biomedical Research Centre
Neubauer, Stefan
United Kingdom, Oxford
Nihr Oxford Biomedical Research Centre
United Kingdom, Oxford
John Radcliffe Hospital
Statistics
Citations: 146
Authors: 12
Affiliations: 4
Identifiers
Doi:
10.1161/CIRCULATIONAHA.113.001719
ISSN:
15244539
Research Areas
Infectious Diseases
Noncommunicable Diseases
Study Design
Cross Sectional Study
Cohort Study