Frequency of development of acute global left ventricular dysfunction in human immunodeficiency virus infection

Institute of the Sixth Medical Clinic, La Sapienza University, Rome, Italy.

OBJECTIVES. This study evaluated prospectively the frequency, clinical outcome and pathologic findings of acute global left ventricular dysfunction in human immunodeficiency virus (HIV) infection during the various stages of the disease. BACKGROUND. Acute global left ventricular dysfunction in the course of HIV infection is still a poorly defined clinical entity, and little is known about the outcome after the acute onset. METHODS. Between January 1988 and June 1992, 136 HIV-positive (HIV+) patients without clinical, electrocardiographic or echocardiographic evidence of cardiovascular dysfunction on admission were prospectively studied with serial echocardiograms. Patients were assigned to three groups: 1) anti-HIV+ asymptomatic (17 patients, 12.5%); 2) acquired immunodeficiency syndrome (AIDS)-related complex (26 patients, 19.1%); 3) AIDS (93 patients, 68.4%). RESULTS. During a mean follow-up period of 415 +/- 220 days, seven patients, all in the AIDS subgroup, developed clinical and echocardiographic findings of acute global left ventricular dysfunction; of these, six (85%) died of congestive heart failure. Mean survival time from symptom onset was 41 +/- 13 days. Necropsy findings in five patients revealed acute lymphocytic myocarditis in three, cryptococcal myocarditis in one and interstitial edema and fibrosis in one. In only one patient was left ventricular dysfunction reversible with treatment. CONCLUSIONS. Although infrequent, acute global left ventricular dysfunction is not rare in the course of HIV infection. It seems to occur exclusively during the AIDS stage. Acute global left ventricular dysfunction is often fatal but may be reversible and is mainly associated with the pathologic findings of acute myocarditis.

This article has been cited by other articles:

				R. P. Shannon, M. A. Simon, M. A. Mathier, Y.-J. Geng, S. Mankad, and A. A. Lackner Dilated Cardiomyopathy Associated With Simian AIDS in Nonhuman Primates Circulation, January 18, 2000; 101(2): 185 - 193. [Abstract] [Full Text] [PDF]

				D. L. Noah, M. A. Blum, and B. Sherry Interferon Regulatory Factor 3 Is Required for Viral Induction of Beta Interferon in Primary Cardiac Myocyte Cultures J. Virol., December 1, 1999; 73(12): 10208 - 10213. [Abstract] [Full Text] [PDF]

				P F Currie, J H Goldman, A L P Caforio, A J Jacob, M K Baig, R P Brettle, A J Haven, N A Boon, and W J McKenna Cardiac autoimmunity in HIV related heart muscle disease Heart, June 1, 1998; 79(6): 599 - 604. [Abstract] [Full Text]

				B. Sherry, J. Torres, and M. A. Blum Reovirus Induction of and Sensitivity to Beta Interferon in Cardiac Myocyte Cultures Correlate with Induction of Myocarditis and Are Determined by Viral Core Proteins J. Virol., February 1, 1998; 72(2): 1314 - 1323. [Abstract] [Full Text] [PDF]