Cardiac autonomic dysfunction in AIDS is not secondary to heart failure

Objective: Heart rate variability (HRV) is a marker of cardiovascular auton omic tone, and is also known to be reduced in association with cardiac dysf unction. Abnormal autonomic function tests are common in HIV infected indiv iduals, but the contribution of heart disease to such findings is not known . Spectral analysis of heart rate variability is a sensitive technique for measurement of cardiovascular autonomic function, which also allows differe ntial assessment of parasympathetic and sympathetic components. The aim of this study was to characterise the nature of autonomic dysfunction in patie nts with AIDS and to compare our findings with those seen in HIV seronegati ve patients with established heart disease. Methods. HRV was measured prosp ectively by spectral analysis in 10 subjects with dilated cardiomyopathy (a ge 45.7+/-6.9 years), 10 subjects with IUDS and no clinical evidence of hea rt disease (age 37.9+/-5.4 years), and 10 healthy HIV seronegative controls (age 41.7+/-13.9 years). Results: All components of HRV were reduced in su bjects with cardiomyopathy (P<0.005), and markedly so in subjects with AIDS (P<0.0001) compared with controls. Conclusions: HIV infection may be assoc iated with severe global autonomic dysfunction, which is not related to hea rt disease. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.