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Cardiac Mechanics in Patients With Human Immunodeficiency Virus: A Study of Systolic Myocardial Deformation in Children and Young Adults

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Abstract

Human immunodeficiency virus (HIV) infection causes dysfunction of different organ systems. Myocardial diastolic dysfunction has been reported previously in an adult HIV population. Our aim was to study myocardial strain in children and young adults infected by HIV who have apparently normal ejection fraction. Forty HIV-infected patients (mean age 20.6 ± 1.5 years) with normal ejection fraction and 55 matched normal controls (mean age 17 ± 1.5 years) were studied by two-dimensional echocardiogram. The images were stored then exported to velocity vector imaging software for analysis. Measures considered were left-ventricular peak global systolic strain (LV S) and strain rate (LV SR) as well as right-ventricular peak global systolic strain (RV S) and strain rate (RV SR). Circumferential measures of the left ventricle included the following: LV circumferential peak global systolic strain (LV circ S), strain rate (LV circ SR), radial velocity (LV rad vel), and rotational velocity (LV rot vel) at the level of the mitral valve. Statistical significance was set at p < 0.05. The means of all longitudinal deformation parameters were significantly lower in HIV patients compared with normal controls: LV S (−14.15 vs. −19.31), LV SR (−0.88 vs. −1.30), RV S (−19.58 vs. −25.09), and RV SR (−1.34 vs. −2.13), respectively (p < 0.05). LV rot vel was lower in patients compared with controls (43.23 vs. 51.71, p = 0.025). LV circ S, LV circ SR, and LV rad vel showed no significant difference between the two groups (p ≥ 0.05). HIV infection affects longitudinal systolic cardiac strain and strain rate in children and young adults. Normal ejection fraction might be attributed to preserved circumferential myocardial deformation. Strain and strain rate may help identify HIV patients at high risk for cardiac dysfunction and allow early detection of silent myocardial depression.

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Authors and Affiliations

  1. Departments of Pediatrics, Pediatric Infectious Disease and Cardiology, St. Joseph’s Regional Medical Center, Paterson, NJ, 07503, USA

    Ghassan Al-Naami, Fuad Kiblawi, Helen Kest, Ayman Hamdan & Dorothy Myridakis

  2. 202-9914 Morrison St, Fort Mcmurray, AB, T9H 4A4, Canada

    Ghassan Al-Naami

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  1. Ghassan Al-Naami
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  2. Fuad Kiblawi
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  3. Helen Kest
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  4. Ayman Hamdan
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  5. Dorothy Myridakis
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Correspondence to Ghassan Al-Naami.

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Al-Naami, G., Kiblawi, F., Kest, H. et al. Cardiac Mechanics in Patients With Human Immunodeficiency Virus: A Study of Systolic Myocardial Deformation in Children and Young Adults. Pediatr Cardiol 35, 1046–1051 (2014). https://doi.org/10.1007/s00246-014-0896-4

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  • DOI: https://doi.org/10.1007/s00246-014-0896-4

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