Diastolic dysfunction in human immunodeficiency virus infection

Aims. We sought to determine the prevalence and characteristics of echocard iographic abnormalities (systolic and/or diastolic dysfunction, pericardial effusion) in patients with human immunodeficiency virus infection (HIV) wi th no symptoms or previous history of cardiac disease, and compare them wit h a healthy control group. Patients and method. Transthoracic echocardiography was performed in 125 pa tients (73% male, mean age 33.2 +/-6.6 years) with HIV infection without ca rdiac involvement and 47 age and sex-matched healthy volunteers (78% male, 31.6 +/-7.3 years). The immunologic situation was determined by CD, lymphoc yte counts. Results. Abnormal left ventricular relaxation and filling patterns (E/A rel ation 1.31 +/-0.35 in HIV group, 1.66 +/-0.38 in control group, p<0.001; pr essure half-time 57.5<plus/minus>13 in HIV group, 50.6 +/-6.6 in control gr oup, p<0.001), segmental wall-motion abnormalities (15%) and pericardial ef fusion (7.2%) were found in patients with HIV infection. Systolic function (EF 64.8<plus/minus>8.3) and left ventricular dimension (diastolic diameter 4.94 +/-0.55, systolic diameter 3.17 +/-0.51) showed normal patterns and d id not significantly differ from those of the control group. Conclusions. Silent echocardiographic abnormalities in patients with HIV in fection are frequent suggesting a direct myocardial effect of the virus. Th e development of diastolic dysfunction is directly related to a worse immun ologic situation. Prospective studies are needed to clarify the clinical pr ognosis of these asymptomatic abnormalities.