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1994-06-25
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Document 0700
DOCN M9460700
TI Emerging patterns of heart disease in HIV infected homosexual subjects
with and without opportunistic infections; a prospective colour flow
Doppler echocardiographic study.
DT 9408
AU Akhras F; Dubrey S; Gazzard B; Noble MI; Academic Medicine, Charing
Cross and Westminster Medical School,; Chelsea and Westminster Hospital,
London, U.K.
SO Eur Heart J. 1994 Jan;15(1):68-75. Unique Identifier : AIDSLINE
MED/94229107
AB We studied 124 homosexual men aged 36.7 +/- 7.6 years (range 23-57)
using Doppler echocardiography. One hundred and one patients (Group A)
had had acquired immunodeficiency syndrome for 1.6 +/- 1.0 years and 23
patients (Group B) had had HIV infection without opportunistic
infections for 3.2 +/- 2.3 years. Doppler echocardiography was normal in
31% of Group A patients and in 61% of Group B. Pericardial effusion was
found in 44 Group A patients (44%) and two Group B patients (9%). In
Group A, left ventricular dilatation and/or dysfunction were found in 20
patients (20%), aortic root dilatation and regurgitation in eight
patients (8%) and an intracardiac echogenic mass in seven patients (7%);
in Group B one patient (4%) had an intracardiac mass. Forty-four (44%)
Group A patients had cardiac presentations, and of these 22 had
cardiomegaly with clinical signs of heart failure; 10 patients had
tachyarrhythmias compared to only two in Group B. Although the CD4
lymphocyte count (%) was significantly lower in Group A than in Group B
(5.4 +/- 6.1 vs 13.3 +/- 7.3, P < 0.001), the presence of pericardial
effusion, left ventricular dysfunction, right-sided cardiac enlargement
or the duration of HIV infection, did not relate to the CD4 level in
either group. Although often not diagnosed clinically, cardiac
involvement in patients with AIDS is a clinical reality, with
pericardial effusion, cardiomyopathy and left ventricular dysfunction
appearing to have a high prevalence in male homosexual patients with
AIDS. These clinical and echocardiographic findings are associated with
clinically apparent intercurrent opportunistic infections, rather than
the HIV virus per se, or the severity of infection as reflected by the
CD4 count.
DE Acquired Immunodeficiency Syndrome/*COMPLICATIONS/EPIDEMIOLOGY Adult
AIDS-Related Opportunistic Infections/*COMPLICATIONS/EPIDEMIOLOGY
Comparative Study *Echocardiography, Doppler Heart
Diseases/*COMPLICATIONS/EPIDEMIOLOGY/*ULTRASONOGRAPHY *Homosexuality
Human HIV Seropositivity/EPIDEMIOLOGY Male Pericardial
Effusion/*COMPLICATIONS/EPIDEMIOLOGY/*ULTRASONOGRAPHY Prevalence
Prospective Studies JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).