Cardiac dysfunction in pauci symptomatic human immunodeficiency virus patients: a meta-analysis in the highly active antiretroviral therapy era
| Autor: | Walter Grosso Marra, Andrea Calcagno, Pierluigi Omedè, Filippo Sciuto, Claudio Moretti, Giuseppe Biondi-Zoccai, Giorgio Quadri, Fabrizio D'Ascenzo, Simone Frea, Giacomo Frati, Davide Castagno, Fiorenzo Gaita, Stefano Bonora, Enrico Cerrato, Davide Giacomo Presutti |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
medicine.medical_specialty Heart Diseases antiretroviral therapy Adult Antiretroviral Therapy Highly Active HIV Infections drug therapy/physiopathology Heart Diseases physiopathology/virology Humans Middle Aged Stroke Volume physiology Tomography Emission-Computed Single-Photon Diastole heart failure hiv HIV Infections Cochrane Library Coronary artery disease physiopathology/virology Antiretroviral Therapy Highly Active Internal medicine medicine echocardiography Humans Highly Active Myocardial infarction Systole Tomography Tomography Emission-Computed Single-Photon haart business.industry Incidence (epidemiology) drug therapy/physiopathology Stroke Volume Middle Aged medicine.disease Heart failure Meta-analysis physiology Cardiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Heart Journal. 34:1432-1436 |
| ISSN: | 1522-9645 0195-668X |
| DOI: | 10.1093/eurheartj/ehs471 |
| Popis: | Aims Human 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 results Medline, 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][1] ). Conclusions Systolic and diastolic dysfunction represent a common finding in pauci symptomatic HIV-infected patients, regardless to HAART. [1]: #F3 |
| Databáze: | OpenAIRE |
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