TY - JOUR
T1 - Myocardial steatosis among antiretroviral therapy-treated people with human immunodeficiency virus participating in the REPRIEVE trial
AU - Neilan, Tomas G.
AU - Nguyen, Kim Lien
AU - Zaha, Vlad G.
AU - Chew, Kara W.
AU - Morrison, Leavitt
AU - Ntusi, Ntobeko A.B.
AU - Toribio, Mabel
AU - Awadalla, Magid
AU - Drobni, Zsofia D.
AU - Nelson, Michael D.
AU - Burdo, Tricia H.
AU - van Schalkwyk, Marije
AU - Sax, Paul E.
AU - Skiest, Daniel J.
AU - Tashima, Karen
AU - Landovitz, Raphael J.
AU - Daar, Eric
AU - Wurcel, Alysse G.
AU - Robbins, Gregory K.
AU - Bolan, Robert K.
AU - Fitch, Kathleen V.
AU - Currier, Judith S.
AU - Bloomfield, Gerald S.
AU - Desvigne-Nickens, Patrice
AU - Douglas, Pamela S.
AU - Hoffmann, Udo
AU - Grinspoon, Steven K.
AU - Ribaudo, Heather
AU - Dawson, Rodney
AU - Goetz, Matthew Bidwell
AU - Jain, Mamta K.
AU - Warner, Alberta
AU - Szczepaniak, Lidia S.
AU - Zanni, Markella V.
N1 - Funding Information:
This work was supported by the NHLBI (grant numbers U01 HL123336, U01 HL123339 and R01HL137562), with additional support from the NIAID (UM1 AI068636 and UM1 AI106701).
Publisher Copyright:
© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.
PY - 2020/8/1
Y1 - 2020/8/1
N2 - Background. People with human immunodeficiency virus (PWH) face increased risks for heart failure and adverse heart failure outcomes. Myocardial steatosis predisposes to diastolic dysfunction, a heart failure precursor. We aimed to characterize myocardial steatosis and associated potential risk factors among a subset of the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) participants. Methods. Eighty-two PWH without known heart failure successfully underwent cardiovascular magnetic resonance spectroscopy, yielding data on intramyocardial triglyceride (IMTG) content (a continuous marker for myocardial steatosis extent). Logistic regression models were applied to investigate associations between select clinical characteristics and odds of increased or markedly increased IMTG content. Results. Median (Q1, Q3) IMTG content was 0.59% (0.28%, 1.15%). IMTG content was increased (> 0.5%) among 52% and markedly increased (> 1.5%) among 22% of participants. Parameters associated with increased IMTG content included age (P =.013), body mass index (BMI) ≥ 25 kg/m2 (P =.055), history of intravenous drug use (IVDU) (P =.033), and nadir CD4 count < 350 cells/mm3 (P =.055). Age and BMI ≥ 25 kg/m2 were additionally associated with increased odds of markedly increased IMTG content (P =.049 and P =.046, respectively). Conclusions. A substantial proportion of antiretroviral therapy-treated PWH exhibited myocardial steatosis. Age, BMI ≥ 25 kg/m2, low nadir CD4 count, and history of IVDU emerged as possible risk factors for myocardial steatosis in this group.
AB - Background. People with human immunodeficiency virus (PWH) face increased risks for heart failure and adverse heart failure outcomes. Myocardial steatosis predisposes to diastolic dysfunction, a heart failure precursor. We aimed to characterize myocardial steatosis and associated potential risk factors among a subset of the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) participants. Methods. Eighty-two PWH without known heart failure successfully underwent cardiovascular magnetic resonance spectroscopy, yielding data on intramyocardial triglyceride (IMTG) content (a continuous marker for myocardial steatosis extent). Logistic regression models were applied to investigate associations between select clinical characteristics and odds of increased or markedly increased IMTG content. Results. Median (Q1, Q3) IMTG content was 0.59% (0.28%, 1.15%). IMTG content was increased (> 0.5%) among 52% and markedly increased (> 1.5%) among 22% of participants. Parameters associated with increased IMTG content included age (P =.013), body mass index (BMI) ≥ 25 kg/m2 (P =.055), history of intravenous drug use (IVDU) (P =.033), and nadir CD4 count < 350 cells/mm3 (P =.055). Age and BMI ≥ 25 kg/m2 were additionally associated with increased odds of markedly increased IMTG content (P =.049 and P =.046, respectively). Conclusions. A substantial proportion of antiretroviral therapy-treated PWH exhibited myocardial steatosis. Age, BMI ≥ 25 kg/m2, low nadir CD4 count, and history of IVDU emerged as possible risk factors for myocardial steatosis in this group.
KW - Cardiometabolic risk
KW - Cardiovascular magnetic resonance spectroscopy
KW - HIV
KW - Heart failure
KW - Intramyocardial triglyceride content
KW - MRS
KW - Myocardial steatosis
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U2 - 10.1093/infdis/jiaa245
DO - 10.1093/infdis/jiaa245
M3 - Article
C2 - 32645158
AN - SCOPUS:85087844619
SN - 0022-1899
VL - 222
SP - S63-S69
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - Supplement_1
ER -