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A Comparison of Cardiac Function Between HIV-Infected and HIV-Seronegative People With and Without the Metabolic Syndrome.
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Reported by Jules Levin
10th Intl Workshop on Adverse Drug Reactions and Lipodystrophy in HIV, London Nov 6-8 2008
WT Cade1,2, L de las Fuentes3, K Mondy4, DN Reeds5, V Davila-Roman3, A Waggoner3, S Lassa-Claxton2, P Herrero5, KE Yarasheski2, & LR Peterson3.
Divisions of Physical Therapy1, Metabolism2, Cardiology3, Infectious Disease4, Nutrition Science5 & Dept. of Radiology5 St. Louis, MO, USA
AUTHOR CONCLUSIONS
Impaired diastolic function was noted in HIV+ and HIV- with MS. Impaired systolic function was noted in HIV+MS and in HIV as a group. It appears that metabolic complications are associated with diastolic dysfunction, but HIV infection and/or HAART may strengthen this association. HIV-infection is associated with sub-clinical systolic dysfunction, irrespective of the presence of metabolic complications.
INTRODUCTION & PURPOSE
HIV+HAART have been associated with cardiovascular disease (CVD). Diastolic dysfunction is common in HIV-seronegative people with the Metabolic Syndrome (MS), but little is known about cardiac function in HIV+ people with and without MS. The purpose of this study was to determine whether cardiac function is impaired in HIV-infected and HIV-seronegative people with the MS
HYPOTHESIS
HIV+ subjects with the MS (HIV+/MS+) will be lower than HIV+ subjects without the MS (HIV+/MS-), HIV-negative subjects with the MS (HIV-/MS+) and healthy controls (HIV-/MS-) as measured by 2D, Doppler and tissue Doppler imaging echocardiography.
SUBJECTS
54 HIV+/MS+ (20% F), 59 HIV+/MS- (22% F), 32 HIV-/MS+ (15% F), and 35 HIV-/MS- (17% F) (total n=180)
In HIV, MS was defined as ³3 of the following: hypertriglyceridemia; low HDL-chol; glucose intolerance/insulin resistance; central adiposity; or hypertension/BP medication. In HIV+/MS+, the ATP-III criteria were used to define MS.
METHODS & PROCEDURES
Resting systolic and diastolic function was measured using 2D, pulsed-wave Doppler, and tissue Doppler imaging echocardiography. Indices of left ventricular (LV) systolic function included ejection fraction (EF) and systolic mitral annular velocity (Sm). Indices of LV diastolic function included transmitral early to late diastolic filling velocity ratio (E/A), deceleration time (DT), isovolumic relaxation time (IVRT), and early diastolic mitral annular velocity (Em).
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