Myocardial dysfunction in human immunodeficiency virus infection: an echocardiographic study.

OBJECTIVES

To determine the prevalence and characteristics of myocardial dysfunction and other cardiac manifestations in patients with human immunodeficiency virus (HIV) infection.

METHODS

Fifty-two patients with HIV infection were examined and screened for various opportunistic infections. CD4 cell count was done and two dimensional echocardiography was performed.

RESULTS

Echocardiographic findings were identified in 22 of 52 patients (42.3%). Eighteen patients (34.6%) were having reduction in fractional shortening, 10 patients (19.2%) left ventricular diastolic dysfunction, 8 patients (15.4%) global hypokinesia and 6 patients (11.5%) pericardial effusion. Nineteen out of 22 patients having CD4 cell count <100 cells/mm3 had high prevalence of echocardiographic abnormalities. Patients with opportunistic infections had more frequent echocardiographic abnormalities than those without opportunistic infections (P < .001 for TB, candidiasis and various pneumonias).

CONCLUSION

Although often not diagnosed clinically, cardiac involvement in patients with HIV infection is a clinical reality with pericardial effusion, left ventricular diastolic dysfunction, reduction in fractional shortening and global hypokinesia appearing to have a high prevalence. These echocardiographic findings are associated with clinically apparent opportunistic infections and low CD4 cell count.