Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.
Echocardiography detects myocardial damage in AIDS: prospective study in 102 patients.
Eur Heart J. 1988 Aug;9(8):887-92. Unique Identifier : AIDSLINE MED/89030766 Corallo S; Mutinelli MR; Moroni M; Lazzarin A; Celano V; Repossini A; Baroldi G; Division of Cardiology, University Hospital L. Sacco, Milan,; Italy.
Abstract:
Few data are available about cardiac involvement in AIDS. We examined 102 consecutive patients with AIDS diagnosed clinically and serologically (Walter Reed Stage 5 and 6), by means of TM and cross-sectional echocardiography with the aim of detecting cardiac abnormalities. None of the patients had overt clinical signs of heart failure. Fifty-five (54%) patients showed persistent tachycardia, diminished left ventricular (LV) wall thickness (mean 7.6 +/- 0.2 mm) and decreased percentage LV fractional shortening (27 +/- 5). In 42 (41%) there was a globular and poorly contracting LV. Thirty-nine (38%) patients had pericardial effusion which was moderate in 30 and small in nine. In four patients, valvular endocarditic vegetation was shown--on the tricuspid valve in three, on the aortic valve in one: all of them were drug addicts; in three (2.9%) patients a cardiac mass was found which proved to be a localization of Kaposi's sarcoma in two. Twenty-five (24.5%) patients died; necropsy showed cardiac chamber dilation, and thin LV walls in 18. On microscopic examination, myocardial fibrosis and lymphocyte infiltration with cell necrosis were observed. We conclude that cardiac abnormalities are common in AIDS. Impairment in LV contractility as assessed from fractional shortening appears to be the most common echocardiographic finding, followed by LV wall thinning, pericardial effusion and eventually by LV cavity dilation. This evolution is suggestive of myocardial damage and supports the hypothesis that dilated cardiomyopathy may be a cardiac complication of AIDS.
Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS Adult Cardiomyopathy, Congestive/ETIOLOGY *Echocardiography Female Heart Diseases/*DIAGNOSIS/ETIOLOGY Heart Neoplasms/DIAGNOSIS/ETIOLOGY Human Male Myocarditis/DIAGNOSIS/ETIOLOGY Prospective Studies Sarcoma, Kaposi's/DIAGNOSIS/ETIOLOGY JOURNAL ARTICLE
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