Abstract
Background: Of all areas worldwide, sub-Saharan Africa is worst affected by the HIV and/or AIDS epidemic. Cardiovascular manifestations are very common and are a powerful contributor to mortality, but often go undetected. Cardiovascular magnetic resonance (CMR) is the most reliable method of assessing cardiac function and morphology and, with this in mind, we initiated a cross-sectional study comparing CMR-determined morphological and functional parameters in asymptomatic HIV-infected patients who were not yet on treatment and early in the disease, with HIV-uninfected control patients.Objectives: To ascertain whether there were any morphological abnormalities or systolic functional impairments on CMR in untreated asymptomatic HIV-infected patients, compared with HIV-uninfected control individuals.Methods: The CMR studies were performed using a 1.5-T whole-body clinical magnetic resonance 16-channel scanner (Achieva, Philips Medical Systems, Best, The Netherlands), using a cardiac five-element phased-array receiver coil (SENSE coil). Functional assessment was performed on 36 HIV-infected patients and the findings compared with 35 HIV-uninfected control patients who were matched for age and sex.Results: There was no significant difference in systolic function between the HIV-uninfected and the HIV-infected patients. The left ventricular end diastolic mass (LVEDM) was slightly higher in the HIV-infected group, but this was statistically insignificant.Conclusion: No significant differences were found regarding the CMR systolic functional analysis and morphological parameters between the HIV-infected and the healthy volunteers.
Highlights
In the period prior to antiretroviral therapy (ART), the prognosis is poor once the cardiovascular system is affected, which is related in part to the late stage of the disease as well as the fact that certain cardiac complications are in themselves a prominent cause of death.[9]
The major focus of the present study was the comparison of functional and structural abnormalities on Cardiovascular magnetic resonance (CMR) in untreated patients who were HIV-infected with HIV-uninfected patients
According to the statistical analysis tests, a sample size of at least 33 participants per group would have been adequate to detect a significant difference in functional analysis parameters between the groups
Summary
Sub-Saharan Africa has the highest worldwide incidence of HIV and/or AIDS, with approximately 6.5 million South Africans infected; 69% of all adults and 90% of all children who are infected live in this region.[1,2]Cardiovascular manifestations in HIV are very common[3,4,5,6,7,8] but often go undetected owing to symptoms being attributed to other causes such as pulmonary tuberculosis and neurological manifestations.In the period prior to antiretroviral therapy (ART), the prognosis is poor once the cardiovascular system is affected, which is related in part to the late stage of the disease as well as the fact that certain cardiac complications are in themselves a prominent cause of death.[9]In developed countries, coronary artery disease is the most common manifestation, mainly owing to accelerated atherosclerosis in patients on ART treatment.[10]. Cardiovascular manifestations in HIV are very common[3,4,5,6,7,8] but often go undetected owing to symptoms being attributed to other causes such as pulmonary tuberculosis and neurological manifestations. In the period prior to antiretroviral therapy (ART), the prognosis is poor once the cardiovascular system is affected, which is related in part to the late stage of the disease as well as the fact that certain cardiac complications are in themselves a prominent cause of death.[9]. Sub-Saharan Africa is worst affected by the HIV and/or AIDS epidemic. Cardiovascular magnetic resonance (CMR) is the most reliable method of assessing cardiac function and morphology and, with this in mind, we initiated a cross-sectional study comparing CMR-determined morphological and functional parameters in asymptomatic HIV-infected patients who were not yet on treatment and early in the disease, with HIV-uninfected control patients
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