Evaluation of left ventricular systolic function by Myocardial Deformation Imaging in asymptomatic HIV patients

  • Kunjang Sherpa Department of Cardiology, National Academy Of Medical Sciences, Bir hospital, Kathmandu, Nepal
  • Ram Kishor Sah Department of Cardiology, National Academy Of Medical Sciences, Bir hospital, Kathmandu, Nepal
  • Arun Maskey Department of Cardiology, Sahid Gangalal National Heart center, Kathmandu, Nepal
  • Rabi Malla Department of Cardiology, Sahid Gangalal National Heart center, Kathmandu, Nepal
  • Deewakar Sharma Department of Cardiology, Sahid Gangalal National Heart center, Kathmandu, Nepal
  • Sujeeb Rajbhandari Department of Cardiology, Sahid Gangalal National Heart center, Kathmandu, Nepal
  • Man Bahadur KC Department of Cardiology, Sahid Gangalal National Heart center, Kathmandu, Nepal
  • Rikesh Tamrakar Department of Cardiology, Sahid Gangalal National Heart center, Kathmandu, Nepal
  • Sushil Shakya Department of General practice and Emergency medicine / ART clinic, Bir Hospital, Nepal
  • Birat Krishna Timilsina Department of Cardiology, National Academy Of Medical Sciences, Bir hospital, Kathmandu, Nepal
  • Anish Hirachan Department of Cardiology, National Academy Of Medical Sciences, Bir hospital, Kathmandu, Nepal
  • Prabha Chapagain Koirala Department of Cardiology, National Academy Of Medical Sciences, Bir hospital, Kathmandu, Nepal
  • Ajay Adhikari Department of Cardiology, National Academy Of Medical Sciences, Bir hospital, Kathmandu, Nepal
  • Shaneez Nazmy Department of Cardiology, National Academy Of Medical Sciences, Bir hospital, Kathmandu, Nepal
Keywords: Global Longitudinal strain, HIV Infection, LV systolic dysfunction

Abstract

Background and Aims: Despite improvements in clinical care, evidence from both industrialized and developing countries indicates that the prevalence of subclinical cardiac dysfunction in individuals with well-controlled HIV infection may approach 50% and represent a newly recognized comorbid condition. The aim of our study was to reveal abnormalities in cardiac function using conventional transthoracic echocardiography and left ventricular strain imaging in HIV infected patients without cardiovascular disease.

Methods: This was a hospital based, single center descriptive cross-sectional comparative study conducted in National Academy of Medical Sciences (NAMS), Bir Hospital which included HIV patients with baseline examination including a patient medical history, clinical examination, baseline CD4 count, viral load and a standardized transthoracic echocardiography and strain imaging examination and the findings were compared among age and sex frequency matched healthy adult population.

Results: Our study enrolled 142 patients out of which 95 HIV positive patients (mean age 36.7±9.2 years with 58% female) and 47 healthy control (mean age 33.7±8 years with 57.4% female). The median duration of HIV diagnosis was 7 years (IQR 2, 10) and median CD4 count was 464 cells/mm3 (IQR 259,750). There was no significant difference in conventional echocardiographic parameters between two groups except for transmitral E velocity that was lower in HIV group (P value of 0.001). The HIV population has lower mean global longitudinal strain (GLS) value of -19.92% ± 2.54 SD compared to the healthy control population with mean of -21.39% ± 1.54 SD(P value of 0.001) and patients with CD4 count less than 300 cell/mm3 had GLS value significantly lower than -18% (P value of 0.05).

Conclusion: HIV infected population without established cardiovascular disease have subclinical left ventricular dysfunction revealed by GLS imaging technique.

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Published
2019-11-14
How to Cite
Sherpa, K., Sah, R., Maskey, A., Malla, R., Sharma, D., Rajbhandari, S., KC, M., Tamrakar, R., Shakya, S., Timilsina, B., Hirachan, A., Koirala, P., Adhikari, A., & Nazmy, S. (2019). Evaluation of left ventricular systolic function by Myocardial Deformation Imaging in asymptomatic HIV patients. Nepalese Heart Journal, 16(2), 11-15. https://doi.org/10.3126/njh.v16i2.26310
Section
Original Articles