143 - Diastolic Dysfunction among HIV Infected African American Population

Abstract

Background: Cardiac involvement has been documented among HIV infection. The aim of the current study was to analyze the prevalence of cardiac dysfunction among HIV infected African American population. The aim was also to see the relation between CD4 count and the occurrence of diastolic dysfunction. Materials and Methods: 261 HIV infected African American patients who were seen in the Bronx Lebanon hospital and clinics between 2009 and 2014 were retrospectively analyzed. We reviewed the Echocardiogram of all these patients from electronic medical records. Lowest CD4 count and median CD4 count of the patient was also reviewed. Presence of hypertension, diabetes mellitus, hyperlipidemia, presence or absence of smoking; drug usage was also analyzed. Left ventricular mass index and Left ventricular mass was noted. 24 patients had incomplete data and were excluded leaving behind 237 patients. Mean age of the entire study sample was 58. Microsoft Excel 2013 was used for statistical analysis. Results: Mean lowest CD 4 count of the entire sample was 214. The prevalence of systolic dysfunction was 20% and diastolic dysfunction was 78%. Most of the diastolic dysfunction was mild. Grade 1 DD—71%.;Grade 2—22%; grade 3 DD—1% and grade 4 DD—0.5%. Mild systolic dysfunction was seen in 5%, moderate in 8% and severe in 7%. Mean right ventricular systolic pressure of the entire sample was 39. Mean Left ventricular mass index—115. Mean left ventricular mass—206. Coronary artery disease was seen in 7% of the patients. Lower CD4 count was associated with higher left ventricular mass index. (P value-.006). On multivariate analysis involving hypertension, drug use, age, coronary artery disease lower CD4 count had predicted diastolic dysfunction (pvalue- < 0.05). Conclusion: HIV infected African American patients have higher prevalence of diastolic dysfunction compared with the general population. Lower CD 4 count had predicted higher left ventricular mass index. These findings suggest HIV patients manifest mild functional and morphological cardiac manifestations which are independently associated with HIV infection. Also the prevalence of diastolic dysfunction is higher in this population ie 78% when compared to other studies which documented prevalence between 30–40%. This demonstrates HIV infected African American have more chances of diastolic dysfunction than other ethnic groups.