Walpert Allie R, Gupta Mansi, Dunderdale Carolyn N, Haptu Hanna H, Manandhar Monica, deFilippi Christopher R, Burdo Tricia H, Lee Hang, Kwong Raymond Y, Srinivasa Suman
Metabolism Unit.
Division of Infectious Disease.
AIDS. 2025 Sep 1;39(11):1592-1597. doi: 10.1097/QAD.0000000000004252. Epub 2025 Jun 4.
Persons with HIV (PWH) are at risk for myocardial structural changes, which can progress to diastolic dysfunction and heart failure with preserved ejection fraction (HFpEF). We explored the AHA PREVENT HF (Predicting Risk of cardiovascular disease EVENTs for Heart Failure) risk score in relation to cardiac magnetic resonance (CMR) imaging.
This cross-sectional study included 37 PWH on ART, ages 40-65, without known cardiovascular disease (CVD) who underwent CMR.
The risk score was assessed using the AHA PREVENT HF calculator. Scores were correlated to variables on CMR that are known indicators of subclinical myocardial dysfunction [left atrial volume index (LAVI), global longitudinal strain (GLS), and left ventricular mass index (LVMI)] and inflammation [extracellular volume (ECV) and longitudinal relaxation (T1)].
PWH were age 55 (6) years [mean (SD)], predominantly male (76%) and white (57%) with BMI in the obese (≥30 kg/m 2 ) range: 31 (5) kg/m 2 . Median PREVENT HF score was 2.6 (1.4, 4.1)% [median (25th, 75th)]. The PREVENT HF score correlated to LAVI ( ρ = 0.35, P = 0.04), T1 ( ρ = 0.35, P = 0.04), interleukin (IL)-6 ( ρ = 0.36, P = 0.03) and NT-proBNP ( ρ = 0.42, P = 0.01). Risk scores were higher for those meeting clinical cutoffs LAVI >34 ml/m 2 and T1 ≥1250 ms. For predicting LAVI >34 ml/m 2 , a PREVENT HF score of 2.5 was the optimal cutoff [sensitivity 85%, specificity 65%, AUROC 0.769 ( P < 0.05)]. In predicting T1 ≥1250 ms, a PREVENT HF score of 3.6 was the optimal cutoff [71% sensitivity, 95% specificity, AUROC 0.727 ( P < 0.05)].
The PREVENT HF score related to indices of altered myocardial structure and inflammation among asymptomatic PWH with subclinical disease. These data begin to inform us about the utility of PREVENT HF score using radiographic findings, though more studies are needed among PWH to validate its use as a prediction tool.
NCT02740179.
感染HIV的患者（PWH）存在心肌结构改变的风险，这种改变可进展为舒张功能障碍和射血分数保留的心力衰竭（HFpEF）。我们探讨了美国心脏协会（AHA）预防心力衰竭（PREVENT HF）风险评分与心脏磁共振成像（CMR）的关系。
这项横断面研究纳入了37名接受抗逆转录病毒治疗（ART）的PWH，年龄在40 - 65岁之间，无已知心血管疾病（CVD），并接受了CMR检查。
使用AHA PREVENT HF计算器评估风险评分。将评分与CMR上已知的亚临床心肌功能障碍指标[左心房容积指数（LAVI）、整体纵向应变（GLS）和左心室质量指数（LVMI）]以及炎症指标[细胞外容积（ECV）和纵向弛豫（T1）]进行相关性分析。
PWH的年龄为55（6）岁[均值（标准差）]，主要为男性（76%）和白人（57%），体重指数（BMI）处于肥胖（≥30 kg/m²）范围：31（5）kg/m²。PREVENT HF评分的中位数为2.6（1.4，4.1）%[中位数（第25百分位数，第75百分位数）]。PREVENT HF评分与LAVI（ρ = 0.35，P = 0.04）、T1（ρ = 0.35，P = 0.04）、白细胞介素（IL）-6（ρ = 0.36，P = 0.03）和N末端脑钠肽前体（NT-proBNP）（ρ = 0.42，P = 0.01）相关。对于符合临床临界值LAVI > 34 ml/m²和T1≥1250 ms的患者，风险评分更高。对于预测LAVI > 34 ml/m²，PREVENT HF评分为2.5是最佳临界值[敏感性85%，特异性65%，曲线下面积（AUROC）0.769（P < 0.05）]。在预测T1≥1250 ms时，PREVENT HF评分为3.6是最佳临界值[敏感性71%，特异性95%，AUROC 0.727（P < 0.05）]。
在无症状的亚临床疾病PWH中，PREVENT HF评分与心肌结构改变和炎症指标相关。这些数据开始让我们了解使用影像学结果评估PREVENT HF评分的效用，不过还需要在PWH中进行更多研究以验证其作为预测工具的用途。
NCT02740179。
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