Deidda Martino, Dessalvi Christian Cadeddu, Campus Selina, Ortu Francesco, Piano Paolo, Bassareo Pier Paolo, Mercuro Giuseppe
Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, Italy.
J Cardiovasc Echogr. 2018 Oct-Dec;28(4):228-232. doi: 10.4103/jcecho.jcecho_43_18.
Human immunodeficiency virus (HIV) infection may also be associated with cardiac dysfunction, thus negatively affecting patients' morbidity and mortality. This preliminary study aimed at evaluating whether bi-and three-dimensional (3D) strain echocardiographic facilities were able to identify alterations in the right ventricular (RV) function in highly selected - because free from cardiovascular risk factors and other comorbidities - HIV patients.
Eight of these specific HIV patients (age: 32.0 ± 3.6 years; 7 months) treated with highly active antiretroviral therapy (HAART) were enrolled and compared with 8 sex-, age-, and cardiovascular risk profile-matched healthy individuals. All underwent clinical evaluation and transthoracic echocardiography coupled with tissue Doppler, two-dimensional (2D), and 3D speckle tracking imaging to examine their RV function.
All standard echocardiographic parameters resulted in the normal range, with no significant differences between HIV and controls. On the contrary, 2D longitudinal strain (16.1% ±1.6% vs. 17.8% ±0.9%, = 0.02) and Global 3D strain (28.5% ±3.6% vs. 33.5% ±1.9%, = 0.0002) were reduced in the HIV group. Moreover, Global 3D strain values showed a direct correlation with RV fractional area change values ( = 0.66, = 0.005).
2D longitudinal and 3D Global strain can identify an early asymptomatic RV impairment in HIV patients free from other risk factors and comorbidities. These findings seem to imply that also in treated with HAART and well-controlled HIV patients an early asymptomatic systolic RV dysfunction is present, as a distinctive and separated pathological entity compared with classic HIV-related pulmonary arterial hypertension and left ventricular dysfunction. In these patients, RV dysfunction is not revealed by standard echocardiography.
人类免疫缺陷病毒（HIV）感染也可能与心脏功能障碍有关，从而对患者的发病率和死亡率产生负面影响。这项初步研究旨在评估二维和三维（3D）应变超声心动图设备是否能够识别经过严格筛选（即无心血管危险因素和其他合并症）的HIV患者右心室（RV）功能的改变。
招募了8名接受高效抗逆转录病毒治疗（HAART）的此类特定HIV患者（年龄：32.0±3.6岁；7个月），并与8名性别、年龄和心血管风险状况相匹配的健康个体进行比较。所有人均接受了临床评估以及经胸超声心动图检查，并结合组织多普勒、二维（2D）和三维散斑追踪成像来检查他们的右心室功能。
所有标准超声心动图参数均在正常范围内，HIV患者与对照组之间无显著差异。相反，HIV组的二维纵向应变（16.1%±1.6%对17.8%±0.9%，P=0.02）和三维整体应变（28.5%±3.6%对33.5%±1.9%，P=0.0002）降低。此外，三维整体应变值与右心室面积变化分数值呈直接相关性（r=0.66，P=0.005）。
二维纵向应变和三维整体应变能够识别无其他危险因素和合并症的HIV患者早期无症状的右心室损害。这些发现似乎意味着，即使是接受HAART治疗且病情得到良好控制的HIV患者，也存在早期无症状的收缩期右心室功能障碍，这是一种与经典的HIV相关肺动脉高压和左心室功能障碍不同的独特病理实体。在这些患者中，标准超声心动图未显示右心室功能障碍。
