Depressive Symptoms and Left Ventricular Diastolic Dysfunction Among Men and Women with HIV

Author:

Martinez Claudia1,Haw Nel Jason2,Rodriguez Violeta J.3,Kizer Jorge R.4,Post Wendy S.2,Wu Katherine C.5,Lima Joao A. C.5,Wise Jenni M.6,Alcaide Maria L.1,Plankey Michael7,Konkle-Parker Deborah8,Kozlova Sofia1,Fischl Margaret A.9,Adimora Adaora A.10,Budoff Matthew11,Golzar Yasmeen12,Lazar Jason13,Palella Frank J14,Rodriguez Carlos J.15,Weinstein Andrea M.16,Wingood Gina17,Spence Amanda Blair7,McKay Heather2,Jones Deborah L.18

Affiliation:

1. University of Miami Miller School of Medicine, Florida, USA

2. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA

3. University of Illinois Urbana-Champaign, USA

4. San Francisco Veterans Affairs Health Care System, California, USA

5. Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, Maryland, USA

6. Department of Family, Community, and Health Systems, School of Nursing, University of Alabama at Birmingham, Alabama, USA

7. Department of Medicine, Division of Infectious Disease, Georgetown University Medical Center, Washington, D.C., USA

8. University of Mississippi Medical Center, Schools of Nursing, Medicine and Population Health, Jackson, Mississippi, USA

9. AIDS Clinical Research Unit, University of Miami Miller School of Medicine, Florida, USA

10. Department of Epidemiology, Division of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, North Carolina, USA

11. Lundquist Institute at Harbor-UCLA, UCLA David Geffen School of Medicine, Los Angeles, California, USA

12. Cook County Health, Chicago, Illinois, USA

13. State University of New York Downstate Medical Center, Brooklyn, USA

14. Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA

15. Albert Einstein College of Medicine, Bronx, New York, USA

16. Department of Psychiatry, School of Medicine, University of Pittsburgh, Pennsylvania, USA

17. Columbia University, New York, USA

18. Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Florida, USA

Abstract

Background and Aim: The prevalence of depressive symptoms and major depressive disorder is high among adults living with HIV. Depressive symptoms are associated with increased cardiovascular disease risk. This study examined the association between depressive symptoms and echocardiographic indices of left ventricular diastolic dysfunction (LVDD) among men and women living with and without HIV. Methods: Cross-sectional analysis included individuals in the Multicenter AIDS Cohort Study (MACS) and Women’s Interagency HIV Study (WIHS) who participated in transthoracic echocardiogram substudies and completed measures of depressive symptoms at the same visit as, or up to 6 months prior to, the transthoracic echocardiogram visit. Participants had helper T cells (CD4) >350 cells/mm3 and HIV RNA viral load <499 copies/mL. The presence of LVDD was defined according to the Characterizing Heart Function on Antiretroviral Therapy (CHART) criteria. Secondary outcomes were continuous values of each component of the CHART criteria: left ventricular ejection fraction >50%, septal e’ velocity, lateral e’ velocity, left atrial volume index, left ventricular mass index, and relative wall thickness. Logistic and linear regression were used to adjust for sociodemographic, behavioural, cardiometabolic, and HIV-related factors. Results: Among 874 men (51% with HIV) and 1,191 women (76% with HIV), in whom the overall prevalence of LVDD was 22.5% and depressive symptoms 30.8%, depressive symptoms were not significantly associated with LVDD. The associations between individual LVDD components and depression were in the small to medium range, though generally not significant. Conclusion: Findings warrant further research regarding the association between LVDD and depressive symptoms in the era of combination antiretroviral therapy.

Publisher

European Medical Group

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