Cardiac dysfunction in pauci symptomatic human immunodeficiency virus patients: A meta-analysis in the highly active antiretroviral therapy era

Enrico Cerrato, Fabrizio D'Ascenzo, Giuseppe Biondi-Zoccai, Andrea Calcagno, Simone Frea, Walter Grosso Marra, Davide Castagno, Pierluigi Omedè, Giorgio Quadri, Filippo Sciuto, Davide Presutti, Giacomo Frati, Stefano Bonora, Claudio Moretti, Fiorenzo Gaita

Research output: Contribution to journalArticle

Abstract

AimsHuman immunodeficiency virus infection (HIV) has been associated with cardiac dysfunction that, if present, can negatively affect morbidity and mortality of HIV-infected patients. Unfortunately, many of the studies on this topic were performed before the highly active antiretroviral therapy (HAART) was established. Thus, we performed a comprehensive meta-analysis to critically appraise the incidence of cardiac dysfunction in HIV-infected pauci symptomatic patients.Methods and resultsMedline, Cochrane Library, and Biomed Central were systematically screened for studies reporting on systolic and/or diastolic dysfunctions in HIV pauci-symptomatic patients. Baseline treatment and cardiac imaging data were appraised and pooled with random effect methods computing summary. At pooled analysis, including a total of 2242 patients from 11 studies, an overall average incidence of traditional cardiovascular risk factors was observed, while a low rate of previous coronary artery disease was reported. Incidence of systolic and diastolic left ventricular dysfunction was 8.33% (95% CI: 2.20-14.25) and 43.38% (95% CI: 31.73-55.03), respectively. Diastolic dysfunction was graded as first [31.85% (95% CI: 24.85-43.73)], second [8.53% (95% CI: 2.12-14.93)], and third degree [3.02% (95% CI: 1.78-4.27)]. At multivariate analysis, a high sensitivity C-reactive protein level >5 mg/L, active tobacco smoking and previous history of myocardial infarction were predictors of left ventricular systolic dysfunction [odd ratio 1.70 (95% CI: 1.03-2.77); 1.57 (95% CI: 1.03-2.34); and 15.90 (95% CI: 1.94-329.00), respectively]. Hypertension (OR = 2.30; 95% CI: 1.20-4.50) and older age (OR = 2.50 per 10 years increase; 95% CI: 1.70-3.60) were predictors of left ventricular diastolic dysfunction (Figure 3).ConclusionsSystolic and diastolic dysfunction represent a common finding in pauci symptomatic HIV-infected patients, regardless to HAART.

Original languageEnglish
Pages (from-to)1432-1436
Number of pages5
JournalEuropean Heart Journal
Volume34
Issue number19
DOIs
Publication statusPublished - May 21 2013

Keywords

  • Antiretroviral therapy
  • Echocardiography
  • HAART
  • Heart failure
  • HIV

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Cerrato, E., D'Ascenzo, F., Biondi-Zoccai, G., Calcagno, A., Frea, S., Grosso Marra, W., Castagno, D., Omedè, P., Quadri, G., Sciuto, F., Presutti, D., Frati, G., Bonora, S., Moretti, C., & Gaita, F. (2013). Cardiac dysfunction in pauci symptomatic human immunodeficiency virus patients: A meta-analysis in the highly active antiretroviral therapy era. European Heart Journal, 34(19), 1432-1436. https://doi.org/10.1093/eurheartj/ehs471