Ventricular mass and diastolic function in patients infected by the human immunodeficiency virus
- aDepartment of Internal Medicine, Hospital Juan Ramón Jiménez, Huelva, Spain, bDepartment of Cardiology, Hospital Juan Ramón Jiménez, cDepartment of Epidemiology, Hospital Universitario Puerta del Mar, c/ Avda Ana de Viya 21, 11009 Cádiz, Spain, dDepartment of Internal Medicine, Hospital Universitario Puerta del Mar
- Dr Girón-González lhh{at}hpm.sas.cica.es
- Accepted 16 August 2000
Abstract
OBJECTIVE Echocardiographic and Doppler analysis of myocardial mass and diastolic function in patients infected with HIV.
DESIGN Case–control study.
SETTING Tertiary referral centre, Huelva, Spain.
PATIENTS 61 asymptomatic patients with HIV infection and 32 healthy controls.
MAIN OUTCOME MEASURES Time motion, cross sectional, and Doppler echocardiographic studies were performed, and left ventricular mass and diastolic function variables determined (peak velocity of early and late mitral outflow and isovolumic relaxation time).
RESULTS Left ventricular mass index (LVMI) was decreased in patients compared with healthy controls (mean (SD): 76.7 (23.6) v 118.8 (23.5) g/m2, p < 0.001). Linear regression analysis showed a correlation between LVMI and brachial fat and muscle areas. The ratio of peak velocities of early and late mitral outflow was decreased in HIV infected patients compared with controls (1.19 (0.44)v 1.58 (0.38), p < 0.001). This ratio was exclusively related to haemodynamic variables (heart rate, systolic and diastolic blood pressures). HIV infected patients had a prolonged isovolumic relaxation time (103.0 (10.5) v72.9 (12.9) ms, p < 0.001). Isovolumic relaxation time was correlated only with brachial muscle area on multivariate analysis.
CONCLUSIONS HIV infected patients had a reduced left ventricular mass index and diastolic functional abnormalities. These cardiac abnormalities are predominantly related to nutritional status.
