Abstract | BACKGROUND AND AIM: METHODS: In 32 consecutive HIV patients with either low (n = 29) or intermediate probability (n = 3) of PH at rest, we evaluated the association of isolated ExPH with: time to HIV diagnosis; CD4+ T-cell count; clinical progression to acquired immunodeficiency syndrome ( AIDS); development of resistance to antiretroviral therapy (ART); HIV RNA levels; time to beginning of ART; current use of protease inhibitors; combination of ART with boosters ( ritonavir or cobicistat); immuno-virologic response to ART; and ART discontinuation. Isolated ExPH at stress echocardiography (ESE) was defined as absence of PH at rest and systolic pulmonary arterial pressure (sPAP) >45 mmHg or a >20 mmHg increase during low-intensity exercise cardiac output (<10 L/min). RESULTS: In our cohort, 22% (n = 7) of the enrolled population developed ExPH which was inversely related to CD4+ T-cell count (p = 0.047), time to HIV diagnosis (p = 0.014) and time to onset of ART (p = 0.041). Patients with ExPH had a worse functional class than patients without ExPH (p < 0.001). ExPH and AIDS showed a trend (p = 0.093) to a direct relationship. AIDS patients had a higher pulmonary vascular resistance compared to patients without ExPH (p = 0.020) at rest echocardiography. CONCLUSIONS: The presence of isolated ExPH associates with a worse clinical status and poor immunological control in HIV patients. Assessment of ExPH by ESE may help identify subgroups of HIV patients with a propensity to develop subclinical impairment of pulmonary circulation following poor control of HIV infection.
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Authors | Rosalinda Madonna, Silvia Fabiani, Riccardo Morganti, Arianna Forniti, Matteo Mazzola, Francesco Menichetti, Raffaele De Caterina |
Journal | Vascular pharmacology
(Vascul Pharmacol)
Vol. 139
Pg. 106888
(08 2021)
ISSN: 1879-3649 [Electronic] United States |
PMID | 34182165
(Publication Type: Journal Article)
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Copyright | Copyright © 2021. Published by Elsevier Inc. |
Topics |
- Echocardiography
- Exercise
- HIV Infections
(complications, diagnosis, drug therapy)
- Humans
- Hypertension, Pulmonary
(diagnosis, etiology)
- Pulmonary Arterial Hypertension
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