Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.
Department of Electrocardiography, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
Biosci Trends. 2020 Mar 16;14(1):9-15. doi: 10.5582/bst.2020.01013. Epub 2020 Feb 20.
People living with HIV (PLWH) have an excess risk of cardiovascular diseases (CVD). Electrocardiographic (ECG) abnormalities are independently predictive of incident cardiovascular events in the general population. Our study aimed to evaluate the prevalence and correlates of ECG abnormalities among PLWH in Shanghai, China. We used a cross-sectional design to collect data from Shanghai Public Health Clinical Center, China. A total of 587 HIV-infected patients aged between 18 and 75 years were recruited between January 2015 and February 2016. The overall prevalence of any type of ECG abnormalities was 53.3%. The prevalence of sinus tachycardia, ST-T segment elevation and left ventricular hypertrophy was 23.0%, 18.1%, and 6.8%, respectively. Multivariable logistic regression analysis indicated that ST-T segment elevation was positively associated with higher baseline HIV viral load (≥ 4 log copies/mL), and sinus tachycardia was negatively associated with older age but positively associated with lower CD4 cell count, higher baseline HIV viral load (≥ 4 log copies/mL) and higher lactic dehydrogenase (LDH) level (≥133 mg/dL). Any coded ECG abnormality was positively associated with higher baseline HIV viral load (≥ 4 log copies/mL). ECG abnormalities including sinus tachycardia and ST-T segment elevation are prevalent among Chinese HIV patients, which are significantly associated with immunodeficiency and HIV viral load. Routine ECG screening may be an important part of HIV clinical care in China.
HIV 感染者（PLWH）患心血管疾病（CVD）的风险过高。心电图（ECG）异常是普通人群中心血管事件发生的独立预测因素。我们的研究旨在评估中国上海 HIV 感染者中 ECG 异常的流行率和相关因素。我们采用横断面设计，于 2015 年 1 月至 2016 年 2 月期间在中国上海公共卫生临床中心收集数据。共招募了 587 名年龄在 18 至 75 岁之间的 HIV 感染者。任何类型 ECG 异常的总体患病率为 53.3%。窦性心动过速、ST-T 段抬高和左心室肥厚的患病率分别为 23.0%、18.1%和 6.8%。多变量逻辑回归分析表明，ST-T 段抬高与较高的基线 HIV 病毒载量（≥4 log 拷贝/mL）呈正相关，窦性心动过速与年龄较大呈负相关，但与 CD4 细胞计数较低、较高的基线 HIV 病毒载量（≥4 log 拷贝/mL）和较高的乳酸脱氢酶（LDH）水平（≥133mg/dL）呈正相关。任何编码的 ECG 异常均与较高的基线 HIV 病毒载量（≥4 log 拷贝/mL）呈正相关。包括窦性心动过速和 ST-T 段抬高在内的 ECG 异常在中国 HIV 患者中较为常见，与免疫缺陷和 HIV 病毒载量有显著关联。常规 ECG 筛查可能是中国 HIV 临床护理的重要组成部分。
