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评估感染 HIV 并接受抗逆转录病毒治疗的患者的 Tp-e 间期和 Tp-e:QT 及 Tp-e:QTc 比值。

Evaluation of Tp-e interval and Tp-e: QT and Tp-e: QTc ratios in patients infected with HIV and using antiretroviral therapy.

机构信息

Department of Cardiology, Sancaktepe Şehit Prof Dr İlhan Varank Training and Research Hospital, İstanbul, Turkey.

Department of Clinical Microbiology and İnfectious Disease, Sancaktepe Şehit Prof Dr İlhan Varank Training and Research Hospital, İstanbul, Turkey.

出版信息

Turk Kardiyol Dern Ars. 2021 Mar;49(2):135-142. doi: 10.5543/tkda.2021.76656.

Abstract

OBJECTIVE

Sudden cardiac death (SCD) is one of the causes of death among patients infected with human immunodeficiency virus (HIV). The T peak to T end interval (Tp-e interval) is a parameter that is used in the prediction of SCD. The aim of this study was to investigate the difference in Tp-e interval and Tp: QT and Tp: corrected QT interval (QTc) ratios between patients infected with HIV and healthy individuals as well as in other factors affecting patients infected with HIV.

METHODS

A total of 83 patients infected with HIV with negative HIV ribonucleic acid (RNA) levels who were receiving antiretroviral therapy (ART) and 83 healthy individuals were included in this study. All the participants underwent electrocardiography, their Tp-e and QT intervals were measured, and QTc intervals and Tp-e: QT and Tp-e: QTc ratios were calculated. In addition, in the patients infected with HIV, CD4 and CD8 T-cell count and HIV RNA levels were measured.

RESULTS

The Tp-e interval was found to be longer and the Tp-e: QT and Tp-e: QTc ratios were found to be higher in patients infected with HIV. Nadir CD4 was observed to be an independent predictor of Tp-e interval (p=0.014, β=‒0.28). Furthermore, correlation analysis revealed a negative correlation of the nadir CD4 level and CD4: CD8 ratio with Tp-e interval and Tp-e: QT ratio.

CONCLUSION

Low nadir CD4 and a reversed CD4: CD8 ratio in patients infected with HIV receiving ART were found to be associated with a prolonged Tp-e interval and increased Tp-e: QT and Tp-e: QTc ratios. Thus, more attention should be taken in terms of SCD in patients infected with HIV, especially in those with low nadir CD4 and reversed CD4: CD8 ratio.

摘要

目的

心脏性猝死(SCD)是感染人类免疫缺陷病毒(HIV)患者的死亡原因之一。T 波峰末间期(Tp-e 间期)是预测 SCD 的一个参数。本研究旨在探讨 HIV 感染患者与健康个体之间 Tp-e 间期和 Tp:QT 及 Tp:校正 QT 间期(QTc)比值的差异,以及影响 HIV 感染患者的其他因素。

方法

本研究共纳入 83 例 HIV 载量阴性且接受抗逆转录病毒治疗(ART)的 HIV 感染患者和 83 名健康个体。所有参与者均行心电图检查,测量 Tp-e 间期和 QT 间期,并计算 QTc 间期和 Tp-e:QT 及 Tp-e:QTc 比值。此外,在 HIV 感染患者中还测量了 CD4 和 CD8 T 细胞计数和 HIV RNA 水平。

结果

HIV 感染患者的 Tp-e 间期较长,Tp-e:QT 和 Tp-e:QTc 比值较高。CD4 最低点与 Tp-e 间期独立相关(p=0.014,β=‒0.28)。此外,相关性分析显示 CD4 最低点和 CD4:CD8 比值与 Tp-e 间期和 Tp-e:QT 比值呈负相关。

结论

接受 ART 的 HIV 感染患者的 CD4 最低点较低和 CD4:CD8 比值逆转与 Tp-e 间期延长以及 Tp-e:QT 和 Tp-e:QTc 比值增加有关。因此,在 HIV 感染患者中应更加注意 SCD,尤其是 CD4 最低点较低和 CD4:CD8 比值逆转的患者。

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