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Associations Between HIV Serostatus and Cardiac Structure and Function Evaluated by 2‐Dimensional Echocardiography in the Multicenter AIDS Cohort Study

Year: 2021
Type: article
Abstract: Background We aimed to investigate whether there are differences in cardiac structure and systolic and diastolic function evaluated by 2‐dimensional echocardiography among men living with versus without HIV in the era of combination antiretroviral therapy. Methods and Results We performed a cross‐sectional analysis of 1195 men from MACS (Multicenter AIDS Cohort Study) who completed a transthoracic echocardiogram examination between 2017 and 2019. Associations between HIV serostatus and echocardiographic indices were assessed by multivariable regression analyses, adjusting for demographics and cardiovascular risk factors. Among men who are HIV+, associations between HIV disease severity markers and echocardiographic parameters were also investigated. Average age was 57.1±11.9 years; 29% of the participants were Black, and 55% were HIV+. Most men who were HIV+ (77%) were virally suppressed; 92% received combination antiretroviral therapy. Prevalent left ventricular (LV) systolic dysfunction (ejection fraction <50%) was low and HIV serostatus was not associated with left ventricular ejection fraction. Multivariable adjustment models showed that men who were HIV+ versus those who were HIV− had greater LV mass index and larger left atrial diameter and right ventricular (RV) end‐diastolic area; lower RV function; and higher prevalence of diastolic dysfunction. Higher current CD4+ T cell count ≥400 cell/mm 3 versus <400 was associated with smaller LV diastolic volume and RV area. Virally suppressed men who were HIV+ versus those who were HIV− had higher indexed LV mass and left atrial areas and greater diastolic dysfunction. Conclusions HIV seropositivity was independently associated with greater LV mass index, left atrial and RV sizes, lower RV function and diastolic abnormalities, but not left ventricular ejection fraction, which may herald a future predisposition to heart failure with preserved ejection fraction among men living with HIV.
DOI: 10.1161/jaha.120.019709
Authors: Henrique Doria de Vasconcellos, Wendy S. Post, Ann‐Margret Ervin, Sabina Annette Haberlen, Matthew Budoff, Carlos Malvestutto, Jared W. Magnani, Matthew J. Feinstein, Todd T. Brown, Joao A. C. Lima, Katherine C. Wu
Institutions: Johns Hopkins University, Johns Hopkins Medicine, The Lundquist Institute, Harbor–UCLA Medical Center, The Ohio State University, University of Pittsburgh, Northwestern University
Language: English
Field: Medicine
Open Access status: gold
Estimated APC paid: $3,025
Awards: Center/Coordination, Analysis and Management/MACS, Natural History of AIDS in Homosexual Men, University of Pittsburgh Multicenter AIDS Cohort Study (MACS), Center/Coordination, Analysis and Management/MACS, Institute for Clinical and Translational Research, HIV Prevention Trials Network: Network Laboratory, Multicenter AIDS Cohort Study, Multicenter AIDS Cohort Study - Part B (Baltimore Center), University of Pittsburgh MACS/WIHS CCS, Data Analysis and Coordination Center for the MACS-WIHS Combined Cohort Study, LC: HIV PREVENTION TRIALS NETWORK, Clinical Research Sites for the MACS/WIHS Combined Cohort Study (MACS/WIHS-CCS) - Baltimore/Wash DC Center
OpenAlex ID: W3137293197
FWCI: 6.011
Cites: 35
Cited by: 33
Related to: 10