Cardiovascular Imaging Research Center, Department of Radiology and Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Division of Cardiology, David Geffen School of Medicine at the University of California, Los Angeles and the Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA.
J Infect Dis. 2020 Jul 9;222(Suppl 1):S63-S69. doi: 10.1093/infdis/jiaa245.
People with human immunodeficiency virus (PWH) face increased risks for heart failure and adverse heart failure outcomes. Myocardial steatosis predisposes to diastolic dysfunction, a heart failure precursor. We aimed to characterize myocardial steatosis and associated potential risk factors among a subset of the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) participants.
Eighty-two PWH without known heart failure successfully underwent cardiovascular magnetic resonance spectroscopy, yielding data on intramyocardial triglyceride (IMTG) content (a continuous marker for myocardial steatosis extent). Logistic regression models were applied to investigate associations between select clinical characteristics and odds of increased or markedly increased IMTG content.
Median (Q1, Q3) IMTG content was 0.59% (0.28%, 1.15%). IMTG content was increased (> 0.5%) among 52% and markedly increased (> 1.5%) among 22% of participants. Parameters associated with increased IMTG content included age (P = .013), body mass index (BMI) ≥ 25 kg/m2 (P = .055), history of intravenous drug use (IVDU) (P = .033), and nadir CD4 count < 350 cells/mm³ (P = .055). Age and BMI ≥ 25 kg/m2 were additionally associated with increased odds of markedly increased IMTG content (P = .049 and P = .046, respectively).
A substantial proportion of antiretroviral therapy-treated PWH exhibited myocardial steatosis. Age, BMI ≥ 25 kg/m2, low nadir CD4 count, and history of IVDU emerged as possible risk factors for myocardial steatosis in this group.
NCT02344290; NCT03238755.
人类免疫缺陷病毒（HIV）感染者患心力衰竭和不良心力衰竭结局的风险增加。心肌脂肪变性易患舒张功能障碍，这是心力衰竭的前兆。我们旨在描述随机预防 HIV 血管事件试验（REPRIEVE）参与者亚组的心肌脂肪变性及其相关潜在危险因素。
82 名无已知心力衰竭的 HIV 感染者成功接受了心血管磁共振波谱分析，得出了心肌内甘油三酯（IMTG）含量（心肌脂肪变性程度的连续标志物）的数据。应用逻辑回归模型探讨了一些临床特征与 IMTG 含量增加或明显增加的比值比之间的关系。
中位数（Q1，Q3）IMTG 含量为 0.59%（0.28%，1.15%）。52%的参与者的 IMTG 含量增加（>0.5%），22%的参与者的 IMTG 含量明显增加（>1.5%）。与 IMTG 含量增加相关的参数包括年龄（P=0.013）、体重指数（BMI）≥25kg/m2（P=0.055）、静脉吸毒史（P=0.033）和最低 CD4 计数<350 个细胞/mm³（P=0.055）。年龄和 BMI≥25kg/m2 与明显增加的 IMTG 含量的几率增加也相关（P=0.049 和 P=0.046）。
相当一部分接受抗逆转录病毒治疗的 HIV 感染者存在心肌脂肪变性。年龄、BMI≥25kg/m2、最低 CD4 计数和静脉吸毒史可能是该组人群心肌脂肪变性的危险因素。
NCT02344290；NCT03238755。
