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Prevalence and severity of ventricular dysfunction in patients with HIV-related pulmonary arterial hypertension
Authors:Santo Dellegrottaglie,Ana Garcí  a-Alvarez,Pasquale Guarini,Pasquale Perrone-Filardi,Valentin Fuster,Javier Sanz
Affiliation:1. Division of Cardiology, Ospedale Medico-Chirurgico Accreditato Villa dei Fiori, Acerra, Naples, Italy;2. Z. and M.A. Wiener Cardiovascular Institute and M.-J. and H.R. Kravis Center for Cardiovascular Health, Mount Sinai Medical Center, New York, NY, USA;3. Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain;4. Cardiology Department, Thorax Institute, Hospital Clinic, Institut d''Investigacions Biomediques Agust Pi i Sunyer (IDIBAPS), Barcelona, Spain;5. Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Federico II University, Naples, Italy
Abstract:

Objectives

To evaluate the occurrence of ventricular systolic dysfunction in human immunodeficiency virus (HIV)-related pulmonary arterial hypertension (PAH).

Background

Patients with HIV-related PAH may develop ventricular systolic dysfunction both as a consequence of PAH progression or of the myocardial involvement from the HIV infection itself.

Methods

Cardiac magnetic resonance imaging was applied to measure ejection fraction for the left ventricle and the right ventricle in patients with HIV-related PAH (n = 27) and in patients with PAH from other aetiologies (n = 115).

Results

In HIV-related PAH, ejection fraction values were lower and a higher proportion of patients presented with an advanced stage of ventricular dysfunction (55% vs. 25%; p = 0.009). In a multivariate model, PAH related to HIV infection remained independently associated with advanced ventricular dysfunction (p = 0.011).

Conclusions

Patients with HIV-related PAH have more prevalent and severe ventricular systolic dysfunction compared to patients with PAH from other aetiologies.
Keywords:Human immunodeficiency virus   Pulmonary hypertension   Magnetic resonance imaging   Ventricular function
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