Olalla J, Pombo M, Del Arco A, de la Torre J, Urdiales D, García-Alegría J
Área de Medicina Interna, Agencia Sanitaria Costa del Sol, Consejería de Salud, Junta de Andalucía, Marbella, Málaga, España.
Rev Clin Esp (Barc). 2013 Aug-Sep;213(6):271-7. doi: 10.1016/j.rce.2013.02.001. Epub 2013 Mar 26.
The HIV infection has been associated with an increased incidence of vascular events. Left ventricular mass (LVM) is independently associated with greater overall mortality. Various studies have shown that patients with HIV infection have higher LVM than the uninfected population. We aim to describe the distribution of LVM in an extensive series of patients with HIV infection, and the factors associated with its increase.
A cross-sectional study was performed in HIV-infected patients followed in our center from 1 December 2009 to 28 February 2011. A transthoracic echocardiography (TTE) was performed in all patients who gave their consent. Demographic variables, viroimmunological status, cardiovascular risk factors, vascular risk at 10 years (VR10) and history of exposure to antiretroviral drugs were collected. LVM was considered to be the quantitative dependent variable. A univariate analysis was performed, including in the multivariate analysis those variables with P<,05.
A TTE was performed in 400 patients, and the LVM was calculated in 388. Mean age was 45 years, 75.5 males. Mean LVM was 39.54g/m(2.7)(95% CI: 38.35-40.73). Age, height, body mass index, VR10, hypertension, dyslipidemia, different medications within the cardiovascular area and having taken nevirapine have been used in the history of the patient were associated to greater LVM. In the multivariate analysis, use of nevirapine in the history of the patient and VR10 remained in the model.
VR10 may be associated with greater LVM. The relationship with nevirapine may respond to an indication bias.
HIV感染与血管事件发生率增加有关。左心室质量(LVM)与总体死亡率升高独立相关。多项研究表明,HIV感染患者的LVM高于未感染人群。我们旨在描述大量HIV感染患者中LVM的分布情况以及与其增加相关的因素。
对2009年12月1日至2011年2月28日在我们中心接受随访的HIV感染患者进行了一项横断面研究。所有同意的患者均接受了经胸超声心动图(TTE)检查。收集了人口统计学变量、病毒免疫状态、心血管危险因素、10年血管风险(VR10)以及抗逆转录病毒药物暴露史。LVM被视为定量因变量。进行了单因素分析,多因素分析纳入P<0.05的变量。
400例患者接受了TTE检查,其中388例计算了LVM。平均年龄为45岁,男性75.5例。平均LVM为39.54g/m(2.7)(95%CI:38.35 - 40.73)。患者病史中的年龄、身高、体重指数、VR10、高血压、血脂异常、心血管领域的不同药物使用情况以及曾服用奈韦拉平与较高的LVM相关。多因素分析中,患者病史中使用奈韦拉平和VR10仍在模型中。
VR10可能与较高的LVM相关。与奈韦拉平的关系可能归因于指示偏倚。