SUBCLINICAL CARDIOVASCULAR DISEASE IN PEOPLE LIVING WITH HIV

IF 5.9 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American journal of preventive cardiology Pub Date : 2025-09-01 DOI:10.1016/j.ajpc.2025.101087

MaryElizabeth Simkevich BA , Syed Hashim Bokhari MD , Yash Patel MD, MPH , Melanie Parent BA , Gerald Bloomfield MD, MPH , Michelle Richard MD , Tasnim F. Imran MD, MPH , John McGeary PhD , James Rudolph MD , Gaurav Choudhary MD , Wen-Chih Wu MD, MPH , Sebhat Erqou MD, PhD

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Abstract

Therapeutic Area

ASCVD/CVD Risk Factors

Background

People living with HIV (PLHIV) experience chronic inflammation, which may contribute to tissue fibrosis, premature vascular aging (PVA), and cardiac dysfunction. This cross-sectional pilot study aimed to determine the association of HIV status with cardiorespiratory fitness, inflammation, fibrosis, PVA, and cardiac dysfunction.

Methods

Male veterans, 21 HIV+ and 20 HIV-, were recruited from the Providence VA Medical Center and matched on age (within 5 years), sex, race, and other factors. Participants completed questionnaires, blood tests, a treadmill stress test, echocardiogram, coronary CT scan, and an optional cardiac MRI (CMR). Multivariable linear regressions adjusted for age and smoking status were performed on these data to determine their associations with HIV status.

Results

HIV+ participant age (54.2 ± 11.6 years) was comparable to controls (56.2 ± 11.3 years, p = 0.6), with a similar racial distribution in both groups. HIV status was associated with GDF15, a marker of fibrosis (beta = 109.9, 95% CI [10.6, 209.2], p = 0.031), but not with LogST2, Galectin3 (other markers of fibrosis), Log IL6, or Log CRP (markers of inflammation). HIV+ participants had a higher mean extracellular volume (ECV; a measure of fibrosis on CMR) compared to controls (21.6% vs. 17.9%) and a higher predicted vascular age based on coronary calcium score than controls (55.5 vs. 52.6 years) though neither was statistically significant (p = 0.071, p = 0.645). There was a trend toward a positive association between HIV status and mean ECV (beta = 3.83, 95% CI [-0.30, 8.0], p = 0.067). HIV+ participants had comparable exercise tolerance to controls (11.7 Mets vs 10.4 Mets, p = 0.215). HIV status was negatively associated with right ventricular ejection fraction on CMR (51.8% HIV+ vs. 57.5% Controls, beta= -5.78, 95% CI [-10.8, -0.7], p = 0.027), but not with left ventricular ejection fraction.

Conclusions

Data from this pilot study suggest that HIV+ status is associated with increased myocardial fibrosis and decreased right ventricular function. Further studies are needed to elucidate these findings.

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HIV感染者的亚临床心血管疾病

治疗领域ascvd /CVD危险因素背景HIV感染者（PLHIV）经历慢性炎症，这可能导致组织纤维化、血管过早老化（PVA）和心功能障碍。这项横断面初步研究旨在确定HIV状态与心肺健康、炎症、纤维化、PVA和心功能障碍的关系。方法从维罗维登斯退伍军人医疗中心招募男性退伍军人，HIV阳性21例，HIV阴性20例，年龄（5年内）、性别、种族等因素匹配。参与者完成了问卷调查、血液测试、跑步机压力测试、超声心动图、冠状动脉CT扫描和可选的心脏MRI （CMR）。对这些数据进行了调整年龄和吸烟状况的多变量线性回归，以确定它们与艾滋病毒状态的关系。结果hiv阳性患者的年龄（54.2±11.6岁）与对照组（56.2±11.3岁，p = 0.6）相当，两组的种族分布相似。HIV状态与GDF15（纤维化标志物）相关（β = 109.9,95% CI [10.6, 209.2], p = 0.031），但与LogST2、Galectin3（其他纤维化标志物）、Log IL6或Log CRP（炎症标志物）无关。与对照组相比，HIV阳性参与者的平均细胞外体积（ECV； CMR纤维化指标）更高（21.6%对17.9%），基于冠状动脉钙评分的预测血管年龄也高于对照组（55.5对52.6岁），尽管两者均无统计学意义（p = 0.071,p = 0.645）。HIV状态与平均ECV呈正相关（β = 3.83,95% CI [-0.30, 8.0], p = 0.067）。HIV阳性参与者的运动耐量与对照组相当（11.7 Mets vs 10.4 Mets, p = 0.215）。HIV状态与CMR右心室射血分数呈负相关（HIV阳性51.8% vs.对照组57.5%,β = -5.78, 95% CI [-10.8, -0.7], p = 0.027），但与左心室射血分数无关。该初步研究的数据表明，HIV+状态与心肌纤维化增加和右心室功能下降有关。需要进一步的研究来阐明这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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