心血管疾病(CVD)和心力衰竭(HF)在艾滋病毒感染者中比例过高,并且因性别而异。很少有与CVD相关的研究关注药物使用,然而,它是常见的低收入女性感染艾滋病毒(WLWH),并增加心脏功能障碍。
我们从旧金山社区场馆招募了无庇护和不稳定居住的WLWH,参与了一项为期六个月的队列研究,调查药物使用之间的联系。炎症,和心脏功能障碍。
调整CVD危险因素,共同感染,药物,更年期,我们检查了毒理学证实的药物使用和炎症的影响(C反应蛋白,sCD14,sCD163和sTNFR2)对NT-proBNP水平的影响,心脏伸展和HF的生物标志物。
在74个WLWH中,中位年龄为53岁,45%为黑人.在基线,72%的参与者患有高血压。使用的物质包括烟草(65%),大麻(53%),可卡因(49%),甲基苯丙胺(31%),酒精(28%),阿片类药物(20%)。与NT-proBNP显著相关的因素包括大麻使用(调整后的相对效应[ARE]:-39.6%)和sTNFR2(ARE:65.5%)。调整心力衰竭并将分析限制在受病毒抑制的人身上并没有明显减少影响。使用大麻与sTNFR2无显著相关性,且未改变sTNFR2与NT-proBNP之间的相关性。
在使用WLWH的多物质中,NT-proBNP水平信号心脏拉伸与sTNFR2呈正相关,但在使用大麻的人群中降低了40%。结果是否表明与使用大麻相关的心血管途径减轻了使用多种物质的WLWH的心脏压力和功能障碍,而与炎症无关,值得进一步研究。
Cardiovascular disease (CVD) and heart failure (HF) are disproportionately high in people living with HIV and differ by sex. Few CVD-related studies focus on drug use, yet it is common in low-income women living with HIV (WLWH) and increases cardiac dysfunction.
We recruited unsheltered and unstably housed WLWH from San Francisco community venues to participate in a six-month cohort study investigating linkages between drug use, inflammation, and cardiac dysfunction.
Adjusting for CVD risk factors, co-infections, medications, and menopause, we examined the effects of toxicology-confirmed drug use and inflammation (C-reactive protein, sCD14, sCD163 and
sTNFR2) on levels of NT-proBNP, a biomarker of cardiac stretch and HF.
Among 74 WLWH, the median age was 53 years and 45 % were Black. At baseline, 72 % of participants had hypertension. Substances used included tobacco (65 %), cannabis (53 %), cocaine (49 %), methamphetamine (31 %), alcohol (28 %), and opioids (20 %). Factors significantly associated with NT-proBNP included cannabis use (Adjusted Relative Effect [ARE]: -39.6 %) and
sTNFR2 (ARE: 65.5 %). Adjusting for heart failure and restricting analyses to virally suppressed persons did not diminish effects appreciably. Cannabis use was not significantly associated with
sTNFR2 and did not change the association between
sTNFR2 and NT-proBNP.
Among polysubstance-using WLWH, NT-proBNP levels signaling cardiac stretch were positively associated with
sTNFR2, but 40 % lower in people who used cannabis. Whether results suggest that cardiovascular pathways associated with cannabis use mitigate cardiac stress and dysfunction independent of inflammation in WLWH who use multiple substances merits further investigation.