Cade W T, Reeds D N, Lassa-Claxton S, Davila-Roman V G, Waggoner A D, Powderly W G, Yarasheski K E
Division of Endocrinology, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63108-2212, USA.
HIV Med. 2008 Feb;9(2):96-100. doi: 10.1111/j.1468-1293.2007.00524.x. Epub 2007 Dec 18.
HIV infection and its treatment, specifically protease inhibitor (PI) therapy, have been associated with an increased risk for cardiovascular disease. Heart rate recovery (HRR) following peak exercise is predictive of future cardiovascular events and mortality in the general population. Nothing is known regarding HRR in individuals infected with HIV on highly active antiretroviral therapy (HAART).
HIV-positive subjects on HAART that included a PI (HIV+PI, n=19), HIV-positive subjects on HAART that did not include a PI (HIV+noPI, n=19) and HIV-seronegative age, gender and body mass index (BMI) matched controls (Cntl, n=15) underwent a graded maximal exercise test on a cycle ergometer to volitional exhaustion. A continuous electrocardiogram was recorded and HRR was monitored every 30 s for 2 min post exercise.
HRR at 1.5 and 2 min was significantly delayed in HIV-positive subjects both on and not on PI-based HAART compared with controls (P<0.01).
HRR is impaired in HIV-positive individuals on HAART, whether or not the HAART includes a PI, compared with age, gender, BMI, and activity level matched HIV-seronegative controls. Abnormal HRR may reflect cardio-autonomic dysfunction and may be an independent risk factor for future cardiac events in HIV-positive individuals that receive HAART.
HIV感染及其治疗，尤其是蛋白酶抑制剂（PI）疗法，与心血管疾病风险增加有关。运动峰值后的心率恢复（HRR）可预测普通人群未来的心血管事件和死亡率。对于接受高效抗逆转录病毒治疗（HAART）的HIV感染者的HRR情况，目前尚无相关了解。
接受包含PI的HAART治疗的HIV阳性受试者（HIV+PI组，n=19）、接受不包含PI的HAART治疗的HIV阳性受试者（HIV+noPI组，n=19）以及年龄、性别和体重指数（BMI）匹配的HIV血清阴性对照者（Cntl组，n=15），在功率自行车上进行分级最大运动试验，直至自愿力竭。记录连续心电图，并在运动后2分钟内每隔30秒监测一次HRR。
与对照组相比，接受基于PI的HAART治疗和未接受基于PI的HAART治疗的HIV阳性受试者在运动后1.5分钟和2分钟时的HRR均显著延迟（P<0.01）。
与年龄、性别、BMI和活动水平相匹配的HIV血清阴性对照者相比，接受HAART治疗的HIV阳性个体，无论其HAART治疗方案是否包含PI，HRR均受损。异常的HRR可能反映了心脏自主神经功能障碍，并且可能是接受HAART治疗的HIV阳性个体未来发生心脏事件的独立危险因素。
