04-36 - MYOCARDIAL INVOLVEMENT ASSOCIATED TO HIV INFECTION IN HIGHLY ACTIVE ANTIRETROVIRAL TREATMENT ERA. CONTRIBUTION OF TISSUE DOPPLER AND STRAIN IMAGING: A CASE CONTROL MATCHED STUDY - 09/04/08
Hammoudi [1],
Dr Stephane Ederhy [2],
Dr Emmanuele Di Angelantonio [2],
Pr Pierre Marie Girard [2],
Sylvie Lang [2],
Dr Nabila Haddour [2],
Dr Franck Boccara [2],
Pr Ariel Cohen [2]
Voir les affiliations
Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.
Connectez-vous pour en bénéficier!
Background: Long term cardiac effects of Human Immunodeficiency Virus (HIV) infection and highly active antiretroviral therapy (HAART) on myocardial function remain unclear.
Objective: The aim of our study was to investigate the contribution of Tissue Doppler imaging (TDI) in the evaluation of left (LV) and right ventricular (RV) functions in patients (pts) with HIV infection under HAART.
Methods: Using a case-control design, 47 consecutive HIV pts (mean age 44.7 ± 9.2years, 39 men) with normal conventional echocardiography (defined as LV ejection fraction > 45%, RV fractional area shortening > = 35% and pulmonary artery systolic pressure < 40 mm Hg) and 47 age and sex-matched healthy subjects were prospectively studied.
From pulsed TDI at the tricuspid and mitral annular planes, the following parameters were obtained: tricuspid peak systolic (Sat) and early diastolic (Eat) velocities, mitral early diastolic velocity (Eam), RV isovolumic relaxation time (IVRT) and myocardial performance index (Tei index) for both ventricles. Longitudinal Strain () and systolic Strain rate (SSR) were measured from RV free wall obtained in a modified apical view. We also determined the ratio of early mitral (Em) inflow velocity to Eam (Em/Eam), and of early tricuspid (Et) inflow velocity to Eat (Et/Eat). All the parameters were the average of three measures.
Results: The observed mean values of Et/Eat, IVRT and RV Tei index were significantly higher in HIV pts than in controls (table, mean ± SD). We found no significant differences with regard to Em/Eam, LV Tei index, Sat and RV systolic deformation parameters (, SSR).
In multivariate analysis, HIV infection was independently associated to RV IVRT (ß= 2.12, p < 0.001) and RV Tei index (ß= 0.008, p = 0.009) abnormalities.
Conclusion: In the HAART era, the use of TDI allows to diagnose right ventricular (RV) diastolic function and Tei index abnormalities while RV systolic and LV (systolic and diastolic) functions remain normal.
RV involvement could be an early sign of myocardial impairment in HIV Patients.
© 2007 Elsevier Masson SAS. Tous droits réservés.
Vol 100 - N° 12
P. 1080 - décembre 2007 Retour au numéro
Article précédent
- 04-35 - DOPPLER MYOCARDIAL IMAGING IN THE EVALUATION OF RIGHT VENTRICULAR FUNCTION IN SYSTEMIC SCLEROSIS: A CASE-CONTROL MATCHED STUDY
- Hammoudi, Dr Kiet Tiev, Dr Stephane Ederhy, Dr Gilles Hejblum, Pr Jean Cabane, Pr Ariel Cohen
- 04-37 - MISE EN ÉVIDENCE PAR LE DOPPLER TISSULAIRE DE LA NÉCROSE MYOCARDIQUE ÉTENDUE AU VENTRICULE DROIT. VALIDATION PAR IRM.
- Mathieu Lemercier, Fabrice Bauer, Damien Brunet, Alain Manrique, Jean Nicolas Dacher, Alain Cribier
Bienvenue sur EM-consulte, la référence des professionnels de santé.