HIV causes structural heart disease according to research presented at EuroEcho-Imaging 2013 by Dr Nieves Montoro from Madrid, Spain. The findings support the introduction of cardiovascular screening in all HIV patients, particularly those with a positive blood viral load.
EuroEcho-Imaging 2013 is the official annual meeting of the European Association of Cardiovascular Imaging (EACVI), a registered branch of the European Society of Cardiology (ESC). It takes place during 11-14 December in Istanbul, Turkey, at the Istanbul Lutfi Kýrdar Convention & Exhibition Centre (ICEC).
Dr Montoro said: "It is well known that patients with HIV have a high incidence of structural heart disease (mainly diastolic dysfunction and pulmonary hypertension) as measured by echocardiography but the reason is not clear. We decided to conduct a study to evaluate whether the stage of HIV or the detectable blood viral load were related to the degree of heart disease."
This prospective cohort study included 65 HIV patients (63% male, average age 48 years) who had dyspnoea (shortness of breath) graded as >II on the NYHA scale.1 The stage of HIV was determined by measuring the CD4 count and their opportunistic diseases. Also, the viral blood load was determined. Patients had a transthoracic echocardiogram to assess whether they had structural heart disease (ventricular hypertrophy, systolic or diastolic dysfunction, or pulmonary hypertension). The following cardiovascular risk factors were assessed: hypertension, diabetes, smoking status, dyslipidemia and renal failure.Nearly half of patients (47%) had some form of structural heart disease, mainly left ventricular hypertrophy, left ventricular dysfunction, pulmonary hypertension and signs of right ventricle failure (see figure). Patients with a positive blood viral load had a significantly higher incidence of structural heart disease than those with an undetectable load (75% vs 43%, p
Dr Montoro said: "We found that half of HIV patients with dyspnea had echocardiographic evidence of structural heart disease. Our most interesting finding was that patients with a positive blood viral load had a significantly higher incidence of structural heart disease. In fact, having a detectable blood viral load nearly doubled the prevalence of heart disease, suggesting that HIV itself might be an independent causal agent."
The amount of structural heart disease was not affected by whether or not the patient had AIDS, their gender, age, or presence of cardiovascular risk factors, although this is still a preliminary result and will have to be confirmed in further analysis.
Dr Montoro said: "Our study shows an association between the presence of the virus in the blood and cardiac disease. These findings open the door to the hypothesis that HIV is involved in the aetiology of cardiac damage. It is known that HIV can produce a pro-inflammatory response and this could involve the heart too. We are conducting further studies to test this idea."
She added: "One of the main objectives in HIV treatment is that blood virus levels are undetectable. When it is not achieved, the treatment is usually changed. Our findings show that having any detectable level of virus in the blood nearly doubles the risk of heart disease."
Dr Montoro continued: "Because of the high incidence of cardiac problems in our study (almost 50%) we think that all HIV patients with dyspnoea should undergo a transthoracic echocardiogram to check for structural heart disease. This is a non-invasive, cost-effective and accessible diagnostic test. Furthermore, patients with a positive blood viral load are at nearly twice the risk of structural heart disease and they should receive an echocardiogram whether they are symptomatic or not."
She concluded: "Detecting cardiac problems in HIV patients sooner using a simple diagnostic tool like echocardiography will enable us to treat them in the very early stage of the heart damage and improve their prognosis. Patients found to have a detectable blood viral load and/or structural heart disease should have closer follow up by a cardiologist and their HIV specialist doctor."
Authors:ESC Press Office
About the The European Society of Cardiology (ESC)
The European Society of Cardiology (ESC) represents more than 80 000 cardiology professionals across Europe and the Mediterranean.
About the European Association of Cardiovascular Imaging (EACVI)
The European Association of Cardiovascular Imaging (formerly EAE) is a registered branch of the ESC. Its aim is to promote excellence in clinical diagnosis, research, technical development, and education in cardiovascular ultrasound and other imaging modalities in Europe.
Information for journalists attending EuroEcho-Imaging 2013.EuroEcho-Imaging 2013 takes place during 11-14 December in Istanbul, Turkey, at the Istanbul Lutfi Kýrdar Convention & Exhibition Centre (ICEC). The full scientific programme is available here.
Press Office | EurekAlert!
'Icebreaker' protein opens genome for t cell development, Penn researchers find
21.02.2018 | University of Pennsylvania School of Medicine
Similarities found in cancer initiation in kidney, liver, stomach, pancreas
21.02.2018 | Washington University School of Medicine
For the first time, a team of researchers at the Max-Planck Institute (MPI) for Polymer Research in Mainz, Germany, has succeeded in making an integrated circuit (IC) from just a monolayer of a semiconducting polymer via a bottom-up, self-assembly approach.
In the self-assembly process, the semiconducting polymer arranges itself into an ordered monolayer in a transistor. The transistors are binary switches used...
Breakthrough provides a new concept of the design of molecular motors, sensors and electricity generators at nanoscale
Researchers from the Institute of Organic Chemistry and Biochemistry of the CAS (IOCB Prague), Institute of Physics of the CAS (IP CAS) and Palacký University...
For photographers and scientists, lenses are lifesavers. They reflect and refract light, making possible the imaging systems that drive discovery through the microscope and preserve history through cameras.
But today's glass-based lenses are bulky and resist miniaturization. Next-generation technologies, such as ultrathin cameras or tiny microscopes, require...
Scientists from the University of Zurich have succeeded for the first time in tracking individual stem cells and their neuronal progeny over months within the intact adult brain. This study sheds light on how new neurons are produced throughout life.
The generation of new nerve cells was once thought to taper off at the end of embryonic development. However, recent research has shown that the adult brain...
Theoretical physicists propose to use negative interference to control heat flow in quantum devices. Study published in Physical Review Letters
Quantum computer parts are sensitive and need to be cooled to very low temperatures. Their tiny size makes them particularly susceptible to a temperature...
15.02.2018 | Event News
13.02.2018 | Event News
12.02.2018 | Event News
21.02.2018 | Life Sciences
21.02.2018 | Life Sciences
21.02.2018 | Materials Sciences