The following is the summary of “Left Atrial Mechanics and Diastolic Function Among People Living With Human Immunodeficiency Virus (from the Veterans Aging Cohort Study)” published in the January 2023 issue of Cardiovascular Disease by Berg, et al.
Subclinical cardiomyopathy, diastolic dysfunction, and an elevated risk of cardiovascular death have all been linked to human immunodeficiency virus (HIV) infection. However, people living with HIV (PLWH) have not been compared to HIV-uninfected (HIV-) controls to determine if there is a difference in left atrial (LA) mechanics and left ventricular (LV) diastolic function. The purpose of this cross-sectional, multi-center analysis of the HIV Cardiovascular Disease substudy of the Veterans Aging Cohort Study database was to look at a group of people living with HIV who are veterans with no history of cardiovascular disease.
A total of 277 people were found to have echocardiograms (180 PLWH and 97 HIV-negative).
Diastolic performance was assessed by calculating phasic strain in the LV and LA. Analysis of variance and ordinal logistic regression with propensity weighting was used to examine the association between LA strain, LV strain, and the severity of diastolic dysfunction. Over 86.1% of the PLWH population had HIV viral loads below <500 copies/ml, and 91.7% received antiretroviral medication. The average incubation period was 9.7 years (± standard deviation, 4.9 years). The LA mechanics and diastolic dysfunction percentage were not different between PLWH and HIV+ veterans (P=0.31). Researchers used logistic regression with propensity weighting and found no correlation between HIV status and diastolic dysfunction.
Diastolic dysfunction was inversely and independently related to both LA reservoir strain and LA conduit strain in both cohorts. Virologically suppressed, antiretroviral-treated PLWH showed no increased risk of LA strain or LV diastolic dysfunction compared to HIV-naive individuals. If these findings hold in other populations, HIV viral suppression may mitigate some of the deleterious effects of the virus on cardiac anatomy and function.
Source: https://www.sciencedirect.com/science/article/abs/pii/S0002914922011286
