Abstract
OBJECTIVE: To determine the prevalence and characteristics of myocardial dysfunction and other cardiac manifestations in acutely ill hospital patients infected with human immunodeficiency virus (HIV) in Zimbabwe. DESIGN: A prospective echocardiographic survey of acutely ill HIV seropositive patients. SETTING: General medical ward, Harare Central Hospital, Zimbabwe. PATIENTS: One hundred and fifty seven HIV seropositive patients admitted with various acute medical conditions over a 12 month period, January to December 1994. MAIN OUTCOME MEASURES: Detection of myocardial dysfunction and other cardiac abnormalities by cross sectional echocardiography. RESULTS: Eighty (51%) men and 77 women were studied (mean (SD) age 34.4 (8.5), range 15-60 years for males and 31.6 (9.0), range 16-65 years for females). They were all heterosexual. None was haemophiliac or an intravenous drug user. Echocardiographic abnormalities were found in 79 (50%) patients: 14/151 (9%) had dilated cardiomyopathy, 33/151 (22%) left ventricular dysfunction, 9/151 isolated right ventricular dilatation, and 30/157 (19%) pericardial disease (28 with effusions, three having tamponade). There were two cases of constrictive pericarditis and one of ascending aortic aneurysm. CONCLUSIONS: There is a high prevalence of echocardiographically detected myocardial and pericardial disease in this group of acutely ill HIV infected patients. Left ventricular dysfunction without dilatation was common, but its significance was not ascertained.
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- Anderson D. W., Virmani R., Reilly J. M., O'Leary T., Cunnion R. E., Robinowitz M., Macher A. M., Punja U., Villaflor S. T., Parrillo J. E. Prevalent myocarditis at necropsy in the acquired immunodeficiency syndrome. J Am Coll Cardiol. 1988 Apr;11(4):792–799. doi: 10.1016/0735-1097(88)90213-6. [DOI] [PubMed] [Google Scholar]
- Blanchard D. G., Hagenhoff C., Chow L. C., McCann H. A., Dittrich H. C. Reversibility of cardiac abnormalities in human immunodeficiency virus (HIV)-infected individuals: a serial echocardiographic study. J Am Coll Cardiol. 1991 May;17(6):1270–1276. doi: 10.1016/s0735-1097(10)80134-2. [DOI] [PubMed] [Google Scholar]
- Calabrese L. H., Proffitt M. R., Yen-Lieberman B., Hobbs R. E., Ratliff N. B. Congestive cardiomyopathy and illness related to the acquired immunodeficiency syndrome (AIDS) associated with isolation of retrovirus from myocardium. Ann Intern Med. 1987 Nov;107(5):691–692. doi: 10.7326/0003-4819-107-5-691. [DOI] [PubMed] [Google Scholar]
- Cammarosano C., Lewis W. Cardiac lesions in acquired immune deficiency syndrome (AIDS). J Am Coll Cardiol. 1985 Mar;5(3):703–706. doi: 10.1016/s0735-1097(85)80397-1. [DOI] [PubMed] [Google Scholar]
- Cegielski J. P., Ramiya K., Lallinger G. J., Mtulia I. A., Mbaga I. M. Pericardial disease and human immunodeficiency virus in Dar es Salaam, Tanzania. Lancet. 1990 Jan 27;335(8683):209–212. doi: 10.1016/0140-6736(90)90288-g. [DOI] [PubMed] [Google Scholar]
- Corallo S., Mutinelli M. R., Moroni M., Lazzarin A., Celano V., Repossini A., Baroldi G. Echocardiography detects myocardial damage in AIDS: prospective study in 102 patients. Eur Heart J. 1988 Aug;9(8):887–892. doi: 10.1093/oxfordjournals.eurheartj.a062583. [DOI] [PubMed] [Google Scholar]
- Currie P. F., Boon N. A. Cardiac involvement in human immunodeficiency virus infection. Q J Med. 1993 Dec;86(12):751–753. [PubMed] [Google Scholar]
- Currie P. F., Jacob A. J., Foreman A. R., Elton R. A., Brettle R. P., Boon N. A. Heart muscle disease related to HIV infection: prognostic implications. BMJ. 1994 Dec 17;309(6969):1605–1607. doi: 10.1136/bmj.309.6969.1605. [DOI] [PMC free article] [PubMed] [Google Scholar]
- De Castro S., d'Amati G., Gallo P., Cartoni D., Santopadre P., Vullo V., Cirelli A., Migliau G. Frequency of development of acute global left ventricular dysfunction in human immunodeficiency virus infection. J Am Coll Cardiol. 1994 Oct;24(4):1018–1024. doi: 10.1016/0735-1097(94)90864-8. [DOI] [PubMed] [Google Scholar]
- Garcia I., Fainstein V., Rios A., Luna M., Mansell P., Reuben J., Hersh E. Nonbacterial thrombotic endocarditis in a male homosexual with Kaposi's sarcoma. Arch Intern Med. 1983 Jun;143(6):1243–1244. doi: 10.1001/archinte.1983.00350060175027. [DOI] [PubMed] [Google Scholar]
- Grody W. W., Cheng L., Lewis W. Infection of the heart by the human immunodeficiency virus. Am J Cardiol. 1990 Jul 15;66(2):203–206. doi: 10.1016/0002-9149(90)90589-s. [DOI] [PubMed] [Google Scholar]
- Gwata T. Cardiomyopathy in Rhodesia. Cent Afr J Med. 1977 Nov;23(11):247–250. [PubMed] [Google Scholar]
- Herskowitz A., Vlahov D., Willoughby S., Chaisson R. E., Schulman S. P., Neumann D. A., Baughman K. L. Prevalence and incidence of left ventricular dysfunction in patients with human immunodeficiency virus infection. Am J Cardiol. 1993 Apr 15;71(11):955–958. doi: 10.1016/0002-9149(93)90913-w. [DOI] [PubMed] [Google Scholar]
- Herskowitz A., Willoughby S. B., Baughman K. L., Schulman S. P., Bartlett J. D. Cardiomyopathy associated with antiretroviral therapy in patients with HIV infection: a report of six cases. Ann Intern Med. 1992 Feb 15;116(4):311–313. doi: 10.7326/0003-4819-116-4-311. [DOI] [PubMed] [Google Scholar]
- Herskowitz A., Wu T. C., Willoughby S. B., Vlahov D., Ansari A. A., Beschorner W. E., Baughman K. L. Myocarditis and cardiotropic viral infection associated with severe left ventricular dysfunction in late-stage infection with human immunodeficiency virus. J Am Coll Cardiol. 1994 Oct;24(4):1025–1032. doi: 10.1016/0735-1097(94)90865-6. [DOI] [PubMed] [Google Scholar]
- Jacob A. J., Boon N. A. HIV cardiomyopathy: a dark cloud with a silver lining? Br Heart J. 1991 Jul;66(1):1–2. doi: 10.1136/hrt.66.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jacob A. J., Sutherland G. R., Bird A. G., Brettle R. P., Ludlam C. A., McMillan A., Boon N. A. Myocardial dysfunction in patients infected with HIV: prevalence and risk factors. Br Heart J. 1992 Dec;68(6):549–553. doi: 10.1136/hrt.68.12.549. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kaul S., Fishbein M. C., Siegel R. J. Cardiac manifestations of acquired immune deficiency syndrome: a 1991 update. Am Heart J. 1991 Aug;122(2):535–544. doi: 10.1016/0002-8703(91)91013-d. [DOI] [PubMed] [Google Scholar]
- Lutalo S. K. Clinical progress of followed-up dilated (congestive) cardiomyopathy patients. Cent Afr J Med. 1988 Feb;34(2):21–25. [PubMed] [Google Scholar]
- Matsuyama T., Kobayashi N., Yamamoto N. Cytokines and HIV infection: is AIDS a tumor necrosis factor disease? AIDS. 1991 Dec;5(12):1405–1417. doi: 10.1097/00002030-199112000-00001. [DOI] [PubMed] [Google Scholar]
- Pozniak A. L., Weinberg J., Mahari M., Neill P., Houston S., Latif A. Tuberculous pericardial effusion associated with HIV infection: a sign of disseminated disease. Tuber Lung Dis. 1994 Aug;75(4):297–300. doi: 10.1016/0962-8479(94)90136-8. [DOI] [PubMed] [Google Scholar]
- Sahn D. J., DeMaria A., Kisslo J., Weyman A. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation. 1978 Dec;58(6):1072–1083. doi: 10.1161/01.cir.58.6.1072. [DOI] [PubMed] [Google Scholar]
- Taelman H., Kagame A., Batungwanayo J., Nyirabareja A., Abdel Aziz M., Blanche P., Bogaerts J., van de Perre P. Pericardial effusion and HIV infection. Lancet. 1990 Apr 14;335(8694):924–924. doi: 10.1016/0140-6736(90)90531-9. [DOI] [PubMed] [Google Scholar]
- Zazzo J. F., Chalas J., Lafont A., Camus F., Chappuis P. Is nonobstructive cardiomyopathy in AIDS a selenium deficiency-related disease? JPEN J Parenter Enteral Nutr. 1988 Sep-Oct;12(5):537–538. doi: 10.1177/0148607188012005537. [DOI] [PubMed] [Google Scholar]