Department of Medicine, School of Medicine and Dentistry, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Komfo Anokye Teaching Hospital, Kumasi, Ghana.
BMC Cardiovasc Disord. 2024 Aug 27;24(1):453. doi: 10.1186/s12872-024-04117-1.
Echocardiography can be used to screen, confirm, and assist in the management of some cardiovascular diseases in people living with human immunodeficiency virus (HIV) (PLWH). Thus, complications from subclinical cardiovascular conditions or more apparent conditions, such as massive pericardial effusion with tamponade, can be promptly identified and managed to minimize cardiovascular morbidity and mortality associated with HIV infection. Since the introduction of antiretroviral therapy (ART) in Ghana approximately two decades ago, studies on the prevalence and patterns of echocardiographic abnormalities among PLWH on ART have been limited. This study was designed to assess the prevalence and patterns of echocardiographic abnormalities among PLWH on ART.
This was a cross-sectional study. PLWH on ART (cases) attending the HIV clinic at Komfo Anokye Teaching Hospital (KATH) and HIV-negative blood donors (controls) were consecutively recruited and enrolled in this study. The interviews were performed via a standardized questionnaire. After a clinical examination was performed, all patients underwent two-dimensional (2D) and Doppler transthoracic echocardiograms. The prevalence and patterns of echocardiographic abnormalities were characterized.
There were 117 patients in each arm of the study. There were more females than males among both the cases (92 (78.6%) and controls (80 (68.4%)); however, the sex distribution was similar between the two groups (p = 0.075). For clinical characteristics such as age, weight, height and blood pressure, there were no statistically significant differences between the cases and controls. Echocardiographic abnormalities were more frequently observed and demonstrated a statistically significant difference between cases and controls, with an overall prevalence of 35.0% among cases and 19.7% among controls (p = 0.008). The echocardiographic abnormalities that demonstrated significant differences between the cases and controls were left ventricular (LV) diastolic dysfunction (28.2% versus 8.6%; p = 0.000) and LV hypertrophy (7% versus 0.9%; p = 0.017).
Nearly 1 in 3 PLWH on ART had an echocardiographic abnormality in this Ghanaian study. Echocardiograms are recommended as helpful screening modalities for diagnosing cardiac abnormalities among PLWH on ART.
超声心动图可用于筛查、确诊并协助管理感染人类免疫缺陷病毒（HIV）的人群（PLWH）的某些心血管疾病。因此，能够及时发现亚临床心血管疾病或更明显的疾病（如大量心包积液压迫心脏）的并发症，并进行处理，从而将与 HIV 感染相关的心血管发病率和死亡率降至最低。自大约二十年前加纳引入抗逆转录病毒治疗（ART）以来，关于接受 ART 的 PLWH 中超声心动图异常的流行率和模式的研究一直很有限。本研究旨在评估接受 ART 的 PLWH 中超声心动图异常的流行率和模式。
这是一项横断面研究。连续招募并纳入在 Komfo Anokye 教学医院（KATH）接受 HIV 门诊治疗的接受 ART 的 PLWH（病例）和 HIV 阴性献血者（对照组）。通过标准化问卷进行访谈。进行临床检查后，所有患者均进行二维（2D）和多普勒经胸超声心动图检查。描述超声心动图异常的流行率和模式。
研究的每个组均有 117 名患者。病例组（92 例，78.6%）和对照组（80 例，68.4%）中女性多于男性，但两组之间的性别分布相似（p=0.075）。病例组和对照组之间在年龄、体重、身高和血压等临床特征方面没有统计学上的显著差异。病例组和对照组之间的超声心动图异常更常见，且差异具有统计学意义，病例组的总体患病率为 35.0%，对照组为 19.7%（p=0.008）。病例组和对照组之间存在显著差异的超声心动图异常是左心室（LV）舒张功能障碍（28.2%比 8.6%；p=0.000）和 LV 肥厚（7%比 0.9%；p=0.017）。
在这项加纳研究中，近 1/3 的接受 ART 的 PLWH 存在超声心动图异常。超声心动图被推荐作为诊断接受 ART 的 PLWH 心脏异常的有用筛查方法。
