Affiliation:
1. Department of Radiology The First Hospital of China Medical University Shenyang China
2. NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine The First Hospital of China Medical University Shenyang China
3. Key Laboratory of AIDS Immunology Chinese Academy of Medical Sciences Shenyang China
4. Key Laboratory of AIDS Immunology of Liaoning Province The First Hospital of China Medical University Shenyang China
5. Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases Hangzhou China
6. Department of Radiology Shengjing Hospital of China Medical University Shenyang China
Abstract
BackgroundDespite the advent of combination antiretroviral therapy, people living with human immunodeficiency virus (PLWH) are at an increased risk for cardiac disease.PurposeTo 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.Study TypeProspective.PopulationA 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).Field Strength/Sequence3.0 T, cardiac MRI including balanced steady‐state free precession (SSFP) for the short‐axis, two‐, three‐, and four‐chamber views were performed.AssessmentAssessment 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.Statistical TestsIndependent t tests, Mann–Whitney U test, Pearson's correlation analysis, and multivariate linear analyses (significance level: P < 0.05).ResultsPLWH 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).ConclusionLA 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.Level of Evidence2Technical EfficacyStage 3
Funder
National Natural Science Foundation of China
National Key Research and Development Program of China
Chinese Academy of Medical Sciences