背景:尽管抗逆转录病毒联合治疗的出现,人类免疫缺陷病毒(PLWH)携带者患心脏病的风险增加.
目的:使用心脏MRI与临床疾病活动标志物的相关性,探讨PLWH中舒张性心房和左心功能不全的存在和程度。
方法:前瞻性。
方法:共有163名参与者,包括101名HIV感染者(年龄:52岁[42-62岁];92%男性)和62名年龄和性别匹配的健康志愿者(年龄:51岁[30-72岁];85%男性)。
■3.0T,心脏MRI包括短轴的平衡稳态自由进动(SSFP),two-,三-,并进行了四腔视图。
结果:用CVI42软件进行心功能评估和应变分析。也在MRI之前收集CD4+T细胞和心脏危险因素的血液样本。
方法:独立t检验,Mann-WhitneyU测试,皮尔逊相关分析,和多元线性分析(显著性水平:P<0.05)。
结果:PLWH具有明显更大的左心房最大容积指数(LAVImax:32.6±8.7vs.28.7±8.1mL/m2),最小值(LAVImin:14.8±5.5vs.11.5±5.4mL/m2,),并且在心房收缩之前(LAVIpre-a:23.4±6.7vs.与健康志愿者相比,19.7±7.2mL/m2)。LA水库(LatEF:55.0±10.2vs.61.4±10.4;SLS:29.0±8.1vs.33.8±11.8),导管(LApEF:28.4±8.2vs.32.3±11.3,P=0.01;Sle:16.3±6.5vs.18.9±8.2),和增压泵功能(LAaEF:37.4±12.4vs.42.7±13.1,P=0.01,Sla:12.7±5.1vs.14.9±5.7)在PLWH中均显著受损。HIV患者的整体周向左心室舒张应变率(LVGCS-d)显着降低。多因素分析结果显示,NadirCD4+T细胞与LVGCS-d存在显著的不良相关性(β=0.51)。
结论:LA结构异常和LV舒张功能不全表现在PLWH,NadirCD4+T细胞计数可能是早期心脏舒张功能障碍的危险因素。
方法:2技术效果:阶段3。
BACKGROUND: Despite the advent of combination antiretroviral therapy, people living with human immunodeficiency virus (PLWH) are at an increased risk for cardiac disease.
OBJECTIVE: To explore the presence and extent of diastolic atrial and left ventricular dysfunction in PLWH using cardiac MRI in correlation with clinical markers of disease activity.
METHODS: Prospective.
METHODS: A total of 163 participants comprising 101 HIV-infected individuals (age: 52 years [42-62 years]; 92% male) and 62 age- and sex-matched healthy volunteers (age: 51 years [30-72 years]; 85% male).
UNASSIGNED: 3.0 T, cardiac MRI including balanced steady-state free precession (SSFP) for the short-axis, two-, three-, and four-chamber views were performed.
RESULTS: Assessment of cardiac function and strain analysis were accomplished by CVI42 software. Blood samples for CD4+ T cells and cardiac risk factors were also collected before MRI.
METHODS: Independent t tests, Mann-Whitney U test, Pearson\'s correlation analysis, and multivariate linear analyses (significance level: P < 0.05).
RESULTS: PLWH had a significantly larger left atrial volume maximum index (LAVImax: 32.6 ± 8.7 vs. 28.7 ± 8.1 mL/m2), minimum (LAVImin: 14.8 ± 5.5 vs. 11.5 ± 5.4 mL/m2,), and prior to atrial contraction (LAVIpre-a: 23.4 ± 6.7 vs. 19.7 ± 7.2 mL/m2) as compared to healthy volunteers. The LA reservoir (LAtEF: 55.0 ± 10.2 vs. 61.4 ± 10.4; Sls: 29.0 ± 8.1 vs. 33.8 ± 11.8), conduit (LApEF: 28.4 ± 8.2 vs. 32.3 ± 11.3, P = 0.01; Sle: 16.3 ± 6.5 vs. 18.9 ± 8.2), and booster pump function (LAaEF: 37.4 ± 12.4 vs. 42.7 ± 13.1, P = 0.01, Sla: 12.7 ± 5.1 vs. 14.9 ± 5.7) were all significant impaired in PLWH. Global circumferential left ventricular diastolic strain rate (LVGCS-d) was significantly lower in the HIV patients. Multivariate analysis results showed that Nadir CD4+ T cells had a significant adverse association with LVGCS-d (β = 0.51).
CONCLUSIONS: LA structure abnormalities and LV diastolic dysfunction were manifested in PLWH, with Nadir CD4+ T cell counts potentially serving as a risk factor for early cardiac diastolic dysfunction.
METHODS: 2 TECHNICAL EFFICACY: Stage 3.