Hutchins Elizabeth, Wang Ruibin, Rahmani Sina, Nakanishi Rine, Haberlen Sabina, Kingsley Lawrence, Witt Mallory D, Palella Frank Joseph, Jacobson Lisa, Budoff Matthew J, Post Wendy S
1Los Angeles Biomedical Research Institute, Torrance, California.
2Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
AIDS Res Hum Retroviruses. 2019 Aug;35(8):755-761. doi: 10.1089/AID.2019.0014. Epub 2019 Jun 3.
HIV infection has been associated with diastolic heart failure and atrial fibrillation. The purpose of this study is to determine whether HIV infection is associated with differences in left ventricular mass (LVM), left ventricular end-diastolic volume (LVEDV), and left atrial volume (LAV) indexed to body surface area (left ventricular mass index, left ventricular end-diastolic volume index [LVEDVI], and left atrial volume index [LAVI], respectively). Cross-sectional study of 721 men [425 HIV-infected (HIV+), 296 HIV-uninfected (HIV-) enrolled in the cardiovascular substudy of the Multicenter AIDS Cohort Study (MACS). Participants underwent cardiac computed tomography imaging. A blinded reader measured LVM, LVEDV, and LAV. We used multivariable linear regression models to evaluate whether LVEDVI, left ventricular mass index (LVMI), and LAVI differed by HIV serostatus, adjusting for demographics and cardiovascular disease risk factors. LVMI was significantly greater in HIV+ compared with HIV- men, with adjusted difference of 2.65 g/m (95% confidence interval 0.53-4.77, < .001). Left ventricular end-diastolic index and LAVI did not differ significantly between the two groups. HIV-related factors (nadir CD4 count, clinical AIDS diagnosis, cumulative antiretroviral therapy use, and cumulative protease inhibitor use) were not significantly associated with LVMI, LVEDVI, or LAVI. LVM was significantly higher in HIV+ than HIV- men, which may contribute to the observed increased risk for diastolic heart failure associated with HIV infection. Although HIV infection has been associated with an increased risk for atrial fibrillation, we did not find any difference in LAV by HIV serostatus.
HIV感染与舒张性心力衰竭和心房颤动有关。本研究的目的是确定HIV感染是否与左心室质量(LVM)、左心室舒张末期容积(LVEDV)以及经体表面积指数化的左心房容积(LAV)(分别为左心室质量指数、左心室舒张末期容积指数[LVEDVI]和左心房容积指数[LAVI])的差异相关。对多中心艾滋病队列研究(MACS)心血管子研究中纳入的721名男性进行横断面研究[425名HIV感染者(HIV+),296名未感染HIV者(HIV-)]。参与者接受了心脏计算机断层扫描成像。一名盲法阅片者测量了LVM、LVEDV和LAV。我们使用多变量线性回归模型来评估LVEDVI、左心室质量指数(LVMI)和LAVI是否因HIV血清学状态而异,并对人口统计学和心血管疾病危险因素进行了校正。与HIV-男性相比,HIV+男性的LVMI显著更高,校正后的差异为2.65 g/m(95%置信区间0.53 - 4.77,P <.001)。两组之间的左心室舒张末期指数和LAVI没有显著差异。HIV相关因素(最低CD4细胞计数、临床艾滋病诊断、累积抗逆转录病毒治疗使用情况和累积蛋白酶抑制剂使用情况)与LVMI、LVEDVI或LAVI没有显著关联。HIV+男性的LVM显著高于HIV-男性,这可能导致观察到的与HIV感染相关的舒张性心力衰竭风险增加。尽管HIV感染与心房颤动风险增加有关,但我们未发现LAV因HIV血清学状态而存在任何差异。