Evaluation of Echocardiographic Abnormalities in HIV Positive Patients Treated with Antiretroviral Medications

Background: Echocardiography is a reliable means for the diagnosis of functional and valvular diseases of the heart in HIV positive and HIV negative pa-tients. The current study was to evaluate echocardiographic abnormalities in HIV positive patients under an antiretroviral therapy (ART) program in Tehran, Imam Khomeini Hospital, Iran. Methods: This is a descriptive cross-sectional study, conducted among 231 HIV-1 positive patients under ART. All HIV positive patients including 150 men (65%) and 81 women (35%) (mean age of 41 years) were assessed by trans-thoracic echocardi-ography (TTE) in Imam Khomeini Hospital, over the period from 2013 to 2014. Results: The mean CD4 count was 408 cell/μl, and the average left ventricular ejec-tion fraction (LVEF) was 59.5%. There was an inverse correlation between age and LVEF level. Nevirapine users showed a significantly higher LVEF than non-users. Left ventricular systolic dysfunction (LVSD) was diagnosed in 5.6% along with the increase in age, while left ventricular diastolic dysfunction (LVDD) was reported in 19.5% of patients associated with age and smoking. Here, the mean systolic pulmo-nary arterial pressure (SPAP) was only 20 mmHg and just four percent of the pa-tients suffered pulmonary hypertension. Almost 44% had a heart valve disorder among which mitral valve prolapse is the most common problem. Pericardial effu-sion was not found in any patients. Conclusion: It seems that heart disorders with no suggestive symptoms in HIV posi-tive patients, and mainly older adults who have traditional risk factors for heart dis-eases, should be seriously considered by health providers.

AIDS, Echocardiography, HAART, Heart Failure, HIV, PAP