Isasti Guillermo, Pérez Isabel, Moreno Tamara, Cabrera Fernando, Palacios Rosario, Santos Jesús
UGC del Corazón, Hospital Universitario Virgen de la Victoria, Málaga, Spain.
AIDS Res Hum Retroviruses. 2013 Jan;29(1):20-4. doi: 10.1089/AID.2012.0096. Epub 2012 Sep 17.
HIV patients have been reported to have a greater prevalence of echocardiographic abnormalities. We aimed to determine the prevalence of these abnormalities and their associated factors. This was an observational study of a cohort of asymptomatic HIV patients. Data were recorded on factors of cardiovascular interest and those related to HIV infection. All the subjects underwent a transthoracic echocardiogram. The study included 196 patients, 85.2% men, mean age 46.4 years, with a mean duration of HIV infection of 123.8 months and 27.6% with AIDS. Of the patients, 94.4% were on antiretroviral therapy and 92.5% of these had an undetectable viral load. The mean CD4 cell count was 544/mm(3). The following echocardiographic abnormalities were found: left ventricular (LV) hypertrophy 28.6%, LV diastolic dysfunction 19.9%, left atrial (LA) dilatation 7.7%, right ventricular (RV) systolic dysfunction 6.1%, pulmonary hypertension 2.6%, RV dilatation 2%, and (LV) systolic dysfunction 1%. LV hypertrophy was associated with diabetes mellitus (OR 5.3, 95% CI 1.8-15.3; p=0.001), LV diastolic dysfunction with age (OR for each extra 5 years 4.4, 95% CI 4.2-4.6; p=0.0001), obesity (OR 4.07, 95% CI 1.6-10.0; p=0.02), alcohol consumption (OR 2.5, 95% CI 1.07-6.2; p=0.03) and lower CD4 cell count (OR for each 10 CD4 cells less 10.02, 95% CI 10.00-10.04; p=0.008), and RV systolic dysfunction with hypertension (OR 5.4, 95% CI 1.6-18.2; p=0.005). Echocardiographic abnormalities in HIV patients were common, especially LV hypertrophy and diastolic dysfunction. Prospective comparative studies involving the general population are needed to determine the prevalence of HIV infection and its treatment in these abnormalities.
据报道，HIV患者超声心动图异常的患病率更高。我们旨在确定这些异常的患病率及其相关因素。这是一项对无症状HIV患者队列的观察性研究。记录了心血管相关因素以及与HIV感染相关的因素。所有受试者均接受了经胸超声心动图检查。该研究纳入了196例患者，其中男性占85.2%，平均年龄46.4岁，HIV感染平均持续时间为123.8个月，27.6%的患者患有艾滋病。在这些患者中，94.4%正在接受抗逆转录病毒治疗，其中92.5%的患者病毒载量检测不到。平均CD4细胞计数为544/mm³。发现了以下超声心动图异常：左心室（LV）肥厚28.6%，左心室舒张功能障碍19.9%，左心房（LA）扩大7.7%，右心室（RV）收缩功能障碍6.1%，肺动脉高压2.6%，右心室扩大2%，左心室收缩功能障碍1%。左心室肥厚与糖尿病相关（比值比5.3，95%可信区间1.8 - 15.3；p = 0.001），左心室舒张功能障碍与年龄相关（每增加5岁的比值比4.4，95%可信区间4.2 - 4.6；p = 0.0001），与肥胖相关（比值比4.07，95%可信区间1.6 - 10.0；p = 0.02），与饮酒相关（比值比2.5，95%可信区间1.07 - 6.2；p = 0.03），与较低的CD4细胞计数相关（每减少10个CD4细胞的比值比10.02，95%可信区间10.00 - 10.04；p = 0.008），右心室收缩功能障碍与高血压相关（比值比5.4，95%可信区间1.6 - 18.2；p = 0.005）。HIV患者的超声心动图异常很常见，尤其是左心室肥厚和舒张功能障碍。需要开展涉及普通人群的前瞻性对照研究，以确定HIV感染及其治疗在这些异常中的患病率。
