Left Ventricular Mass and Diastolic Dysfunction in Children Infected with the Human Immunodeficiency Virus

Abstract

Background: Increased left ventricular mass (LVM) and diastolic dysfunction are associated with higher morbidity and mortality among adult patients with human immunodeficiency virus (HIV) infection. Objective: The objective of the following study is to determine the prevalence of increased LVM and diastolic dysfunction in Nigerian children infected with HIV. Methods: Cross‑sectional comparative study of LVM and left ventricular (LV) diastolic function of 150 HIV‑positive children and controls asymptomatic for cardiac disease. Results: Mean LVM was larger in subjects than controls ‑ 66.5 (95% confidence interval, 63.7‑69.3) versus 56.9 (54.1‑59.7) g/m2 respectively ‑ P < 0.001. An increased LVM was present in 21 (14.0%) subjects and 4 (2.7%) controls ‑ P < 0.001. Mean mitral valve peak flow velocities and pressure gradients for the early and late diastolic waves were higher among HIV positive children than controls (P < 0.001). LV diastolic dysfunction was present in 46 (30.7%) subjects and 19 (12.7%) controls (P < 0.001). Subjects with increased LVM were younger and had more severe disease than those with normal LVM. Subjects and controls were similar with respect to their clinical and immunological stages of disease and use of nucleoside reverse transcriptase inhibitors. Conclusion: Increased LVM and diastolic dysfunction are significantly more common in HIV‑infected children compared with controls and occur in asymptomatic subjects