Mean Coronary Cross-Sectional Area as a Measure of Arterial Remodeling Using Noncontrast CT Imaging in Persons With HIV

Ayoda T. Werede, James G. Terry, Sangeeta Nair, Tecla M. Temu, Bryan E. Shepherd, Samuel S. Bailin, Mona Mashayekhi, Curtis L. Gabriel, Morgan Lima, Beverly Owen Woodward, Latoya Hannah, Simon A. Mallal, Joshua A. Beckman, Jonathan Z. Li, Jesse Fajnzylber, David G. Harrison, John Jeffrey Carr, John R. Koethe, Celestine N. Wanjalla

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Persons with HIV have a higher prevalence of coronary artery disease compared with their HIV-negative coun-terparts. Earlier identification of subclinical atherosclerosis may provide a greater opportunity for cardiovascular disease risk reduction. We investigated coronary cross-sectional area (CorCSA) by noncontrasted computed tomography imaging as a noninvasive measure of arterial remodeling among virally suppressed persons with HIV. METHODS AND RESULTS: We assessed 105 persons with HIV with a spectrum of cardiometabolic health. All participants underwent computed tomography imaging to assess the mean corCSA of the proximal left anterior descending artery and 28 participants underwent additional coronary computed tomography angiography. Partial Spearman rank correlations adjusted for cardiovascular disease risk factors were used to assess relationships of corCSA with anthropometric measurements, HIV-related factors, and plasma cytokines. Mean corCSA measured by noncontrast computed tomography and coronary computed tomography angiography were strongly correlated (ρ=0.91, P<0.0001). Higher mean corCSA was present in those with coronary artery calcium (P=0.005) and it correlated with participants’ atherosclerotic cardiovascular disease risk score (ρ=0.35, P=0.01). After adjusting for established cardiovascular disease risk factors, we observed an inverse relationship between corCSA and CD4+ T-cell count (ρ=−0.2, P=0.047). Removal of age from the model strengthened the relationships between corCSA and antiretroviral therapy duration (from ρ=0.19, P=0.08 to ρ=0.3, P=0.01). CorCSA was also inversely correlated with plasma IL-10 (ρ=−0.25, P=0.03) but had no relationship with IL-6 (ρ=0.11, P=0.4) or IL-1β (ρ=0.08, P=0.5). CONCLUSIONS: Positive coronary arterial remodeling, an imaging marker of subclinical atherosclerosis, is associated with a lower CD4 T-cell count, lower circulating IL-10, and possibly a longer antiretroviral therapy duration in persons with HIV. REGISTRATION:; Unique identifier: NCT04451980.

Original languageEnglish (US)
Article numbere025768
JournalJournal of the American Heart Association
Issue number23
StatePublished - Dec 1 2022
Externally publishedYes


  • cardiovascular diseases
  • coronary arterial calcium
  • coronary artery disease
  • cross-sectional area
  • glycated hemoglobin A
  • interleukin-10
  • interleukin-6

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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