Coronary artery endothelial dysfunction is present in HIV positive individuals without significant coronary artery disease

Micaela Iantorno, Michael Schär, Sahar Soleimanifard, Todd T. Brown, Richard Moore, Patricia Barditch-crovo, Matthias Stuber, Shenghan Lai, Gary Gerstenblith, Robert G. Weiss, Allison G. Hays

Research output: Contribution to journalArticle

Abstract

OBJECTIVE:: HIV+ individuals experience an increased burden of coronary artery disease (CAD) not adequately accounted for by traditional CAD risk factors. Coronary endothelial function (CEF), a barometer of vascular health, is depressed early in atherosclerosis and predicts future events but has not been studied in HIV+ individuals. We tested whether CEF is impaired in HIV+ subjects without CAD as compared to an HIV- population matched for cardiac risk factors. DESIGN/METHODS:: In this observational study, CEF was measured noninvasively by quantifying isometric handgrip exercise (IHE)-induced changes in coronary vasoreactivity with MRI in 18 participants with HIV but no CAD (HIV+CAD-, based on prior imaging), 36 age- and cardiac risk factor-matched healthy participants with neither HIV nor CAD (HIV-CAD-), 41 subjects with no HIV but with known CAD (HIV-CAD+) and 17 subjects with both HIV and CAD (HIV+CAD+). RESULTS:: CEF was significantly depressed in HIV+CAD- subjects as compared to that of risk-factor-matched HIV-CAD- subjects (p?<?0.0001), and was depressed to the level of that in HIV- participants with established CAD. Mean IL-6 levels were higher in HIV+ participants (p?<?0.0001), and inversely related to CEF in the HIV+ subjects (p?=?0.007). CONCLUSIONS:: Marked coronary endothelial dysfunction is present in HIV+ subjects without significant CAD and is as severe as that in clinical CAD patients. Furthermore, endothelial dysfunction appears inversely related to the degree of inflammation in HIV+ subjects, as measured by IL-6. CEF testing in HIV+ patients may be useful for assessing cardiovascular risk and testing new CAD treatment strategies, including those targeting inflammation.

Original languageEnglish (US)
JournalAIDS
DOIs
StateAccepted/In press - Mar 28 2017

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

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