Increased thickness of the wall of coronary vessels is significantly linked to impaired diastolic function in middle-aged people who are HIV positive, even if those individuals have no symptoms of a cardiac issue. The findings come in a new study from the National Institutes of Health (NIH), published in Radiology: Cardiothoracic Imaging. [1]
Thanks to effective drug cocktails, HIV-related deaths have fallen sharply over the last decade. However, as the life expectancy of those suffering from the virus improves, health concerns that correlate to long-term infection are on the rise.
Relevant to this research is a growing body of evidence showing that the “burden of cardiovascular disease is higher in these individuals than in those without HIV, with an estimated fourfold higher rate of sudden cardiac death among persons living with HIV compared with the general population,” the study authors led by Khaled Z. Abd-Elmoniem, PhD, from the NIH wrote.
“The ability to detect early coronary artery disease in persons living with HIV and potentially prevent detrimental effects on the heart muscle is important," Abd-Elmoniem added in a statement. “This research shows the impact of HIV on developing subtle subclinical coronary artery disease and its effects on heart function.”
To measure the heart function of otherwise healthy HIV-positive persons—those at low-risk and with no symptoms of cardiovascular disease or defect—Abd-Elmoniem and his colleagues recruited 74 adults (mean age of 49 years) living with HIV and matched them to 25 others (mean age of 46 years) without HIV. The entire cohort had no symptoms of cardiovascular disease prior to the study, and the control group had no significant medical conditions that could skew the comparative analysis.
The two groups were matched based on corresponding age, sex and race. All 99 participants underwent an MRI to measure the thickness of the coronary vessel walls, followed by an echocardiogram to assess the left ventricular function of their heart. Compared to the control group, results showed increased coronary vessel wall thickness in persons with HIV (1.47 mm ± 0.22 vs 1.34 mm ± 0.18; P = .006), itself a sign of coronary artery disease.
The thickening of the artery wall is linked with “increased restriction of diastolic function indicated with lower ratio of left ventricular–filling peak blood flow velocity in early diastole to that in late diastole” and a “higher left ventricular mass index,” the authors wrote.
Curiously, the thickening of the wall of coronary vessels was also independently connected to the drug didanosine, a common HIV treatment taken by some of the HIV-positive cohort. However, signs of coronary artery disease were still found in HIV-positive participants who did not take didanosine.
Given the complications in the findings and the small sample size, further research is necessary to assess in detail the actual risk HIV infection poses for coronary artery disease.
The full study is available at the link below.
Chad is an award-winning writer and editor with over 15 years of experience working in media. He has a decade-long professional background in healthcare, working as a writer and in public relations.