Department of Cardiology, Sancaktepe Şehit Prof İlhan Varank Training and Research Hospital, Istanbul, Turkey.
Department of Infectious Diseases and Clinical Microbiology, Sancaktepe Şehit Prof İlhan Varank Training and Research Hospital, Istanbul, Turkey.
Rev Port Cardiol (Engl Ed). 2020 Mar;39(3):155-160. doi: 10.1016/j.repc.2019.04.010. Epub 2020 Apr 16.
Sudden cardiac death (SCD) plays an important part in all-cause mortality in patients infected with human immunodeficiency virus (HIV). The T-peak to T-end (Tp-e) interval, corrected Tp-e (Tp-ec) interval, and Tp-e/QT ratio on the ECG are parameters used to stratify risk for SCD. The objective of this study was to investigate the differences between HIV-infected patients and healthy individuals in terms of Tp-e interval, Tp-ec interval, and Tp-e/QT ratio, as well as other influencing factors.
Ninety-eight HIV-infected patients and 62 healthy controls were included in this prospective case-control study. Tp-e interval, Tp-ec interval, and Tp-e/QT ratio were measured in all participants. Echocardiographic examination and routine laboratory analysis were performed. In addition, CD4 T-cell count and HIV RNA levels were assessed in HIV-infected patients.
All baseline characteristics were comparable in both groups. The median survival of those living with HIV was 20.63 months; 53% of them had controlled viral load, and 74% were receiving antiretroviral therapy. Mean baseline CD4 T-cell count was 409. In HIV-infected patients, the Tp-e interval and Tp-ec interval were prolonged, and the Tp-e/QT ratio was higher (p<0.001, p<0.001 and p=0.021, respectively). In bivariate and partial correlation analyses, there was a negative correlation between CD4 T-cell level and Tp-e interval, Tp-ec interval, and Tp-e/QT ratio.
Tp-e interval, Tp-ec interval, and Tp-e/QT ratio were greater in HIV-infected patients compared with healthy individuals. HIV-infected patients, particularly those with low baseline CD4 T-cell counts, should be closely monitored due to risk of SCD.
在感染人类免疫缺陷病毒(HIV)的患者中,心源性猝死(SCD)在全因死亡率中占重要地位。心电图上的 T 波峰至 T 波末(Tp-e)间期、校正的 Tp-e(Tp-ec)间期和 Tp-e/QT 比值是用于分层 SCD 风险的参数。本研究的目的是探讨 HIV 感染患者与健康个体之间 Tp-e 间期、Tp-ec 间期和 Tp-e/QT 比值的差异,以及其他影响因素。
本前瞻性病例对照研究纳入了 98 例 HIV 感染患者和 62 名健康对照者。所有参与者均测量了 Tp-e 间期、Tp-ec 间期和 Tp-e/QT 比值。进行了超声心动图检查和常规实验室分析。此外,还评估了 HIV 感染患者的 CD4 T 细胞计数和 HIV RNA 水平。
两组的所有基线特征均相似。HIV 感染者的中位生存时间为 20.63 个月;53%的患者病毒载量得到控制,74%的患者接受了抗逆转录病毒治疗。基线 CD4 T 细胞计数平均为 409。在 HIV 感染者中,Tp-e 间期和 Tp-ec 间期延长,Tp-e/QT 比值升高(p<0.001,p<0.001 和 p=0.021,分别)。在双变量和偏相关分析中,CD4 T 细胞水平与 Tp-e 间期、Tp-ec 间期和 Tp-e/QT 比值呈负相关。
与健康个体相比,HIV 感染患者的 Tp-e 间期、Tp-ec 间期和 Tp-e/QT 比值更大。由于 SCD 的风险,HIV 感染者,特别是基线 CD4 T 细胞计数较低的患者,应密切监测。