Prospective cardiac magnetic resonance study of myocardial injury in AIDS patients

doi:10.19871/j.cnki.xfcrbzz.2022.03.009

Abstract

Abstract: Objective To evaluate the changes of myocardial tissue and cardiac function in AIDS patients by cardiac magnetic resonance imaging (CMR). Method 45 male AIDS patients and 18 healthy controls were prospectively included for CMR scanning. Post-processing analysis was performed to evaluate cardiac involvement. Myocardial tissue changes, including edema, microcirculation disorders and fibrosis; including cardiac function indexes, volume parameters, ejection fraction and left ventricular remodeling index (LVRI); Changes in mitral and tricuspid valve structure and function were assessed. Furthermore, the cardiac function indexes of AIDS patients with/without heart involvement and normal controls were compared. Result 16 cases (35.5%) of AIDS patients presented with cardiac involvement, including reduced systolic function of left and right ventricles, myocardial edema, the mitral and tricuspid valves thickened, triapphal regurgitation and myocardial microcirculation disturbance. There was no significant reduction in left and right ventricular volume parameters in AIDS patients with/without cardiac involvement compared with normal controls (all P>0.05). The left ventricular ejection fraction and left ventricular stroke volume of AIDS patients with heart involvement showed a decreasing trend compared with AIDS patients without heart involvement and normal control. The left ventricular remodeling index of AIDS patients without heart involvement was significantly higher than that of the normal control (1.62±0.26 vs 1.45±0.24, P=0.025), and the LVRI of AIDS patients with heart involvement was not significantly higher than that of the normal control. Conclusion Cardiac involvement in patients with HIV/AIDS is common, such as changes in valves, cardiac dysfunction, myocardial edema and microcirculation, etc. HIV/AIDS patients have developed left ventricular remodeling when the left ventricular volume and ejection fraction has not significantly change in the early stage. CMR could provide more comprehensive objective evidence for assessing myocardial injury of AIDS patients in the early stage.

Key words: Acquired immune deficiency syndrome, Cardiac magnetic resonance, Myocardial injury, Prospective study

Zhang Na, Jiang Nan, Gao Yueqin, Cai Lin, Xie liqiu, Xie Xianwei, Zheng Haiyan, Hou Keke. Prospective cardiac magnetic resonance study of myocardial injury in AIDS patients[J]. Electronic Journal of Emerging Infectious Diseases, 2022, 7(3): 41-45.

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