Dilated heart muscle disease associated with HIV infection

A. Herskowitz, S. B. Willoughby, D. Vlahov, K. L. Baughman, A. A. Ansari

    Research output: Contribution to journalArticle

    Abstract

    As more effective therapies have produced longer survival times for HIV-infected patients, non-infectious complications of late stage HIV infection such as the development of severe global left ventricular dysfunction (dilated heart muscle disease) have emerged. The demographic and clinical characteristics of HIV-infected patients who develop dilated heart muscle disease as well as potential risk factors are, as yet, poorly characterized. Of 174 patients enrolled in a prospective longitudinal study, a total of nine patients, all with CD4 T cell counts <200 mm-3, developed symptomatic heart disease (congestive heart failure n = 7, sudden cardiac death n = 1 and cardiac tamponade n = 1); three of these patients developed progressive cardiac dysfunction lending to primary cardiac failure and death. An additional 55 HIV-infected patients referred to our Cardiomyopathy Service were found to have global left ventricular dysfunction, with 84% having New York Heart Association Class III or IV congestive heart failure on presentation. Clinical characteristics associated with severe symptomatic cardiac dysfunction included low CD4 T cell counts, myocarditis associated with non-permissive cardiotropic virus infection on endomyocardial biopsy and persistent elevation of anti-heart antibodies no relationships to any specific HIV risk factor or opportunistic infection were found. These findings suggest that a severe form of HIV-related dilated heart muscle disease is largely a disease of late stage HIV infection. Virus-related myocarditis and cardiac autoimmunity may play a role in the pathogenesis of progressive cardiac injury. Long-term longitudinal studies of larger HIV-infected cohorts are warranted to identify clinical, behavioral and immunologic risk factors.

    Original languageEnglish (US)
    Pages (from-to)50-55
    Number of pages6
    JournalEuropean Heart Journal
    Volume16
    Issue numberSUPPL. O
    StatePublished - 1995

    Fingerprint

    HIV Infections
    Heart Diseases
    Myocardium
    HIV
    Heart Failure
    Myocarditis
    Left Ventricular Dysfunction
    CD4 Lymphocyte Count
    Longitudinal Studies
    T-Lymphocytes
    Cardiac Tamponade
    Sudden Cardiac Death
    Opportunistic Infections
    Immunologic Factors
    Virus Diseases
    Autoimmunity
    Cardiomyopathies
    Anti-Idiotypic Antibodies
    Demography
    Prospective Studies

    Keywords

    • Acquired immunodeficiency syndrome
    • Cytomegalovirus
    • Dilated heart muscle disease
    • HIV
    • Myocarditis

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine

    Cite this

    Herskowitz, A., Willoughby, S. B., Vlahov, D., Baughman, K. L., & Ansari, A. A. (1995). Dilated heart muscle disease associated with HIV infection. European Heart Journal, 16(SUPPL. O), 50-55.

    Dilated heart muscle disease associated with HIV infection. / Herskowitz, A.; Willoughby, S. B.; Vlahov, D.; Baughman, K. L.; Ansari, A. A.

    In: European Heart Journal, Vol. 16, No. SUPPL. O, 1995, p. 50-55.

    Research output: Contribution to journalArticle

    Herskowitz, A, Willoughby, SB, Vlahov, D, Baughman, KL & Ansari, AA 1995, 'Dilated heart muscle disease associated with HIV infection', European Heart Journal, vol. 16, no. SUPPL. O, pp. 50-55.
    Herskowitz A, Willoughby SB, Vlahov D, Baughman KL, Ansari AA. Dilated heart muscle disease associated with HIV infection. European Heart Journal. 1995;16(SUPPL. O):50-55.
    Herskowitz, A. ; Willoughby, S. B. ; Vlahov, D. ; Baughman, K. L. ; Ansari, A. A. / Dilated heart muscle disease associated with HIV infection. In: European Heart Journal. 1995 ; Vol. 16, No. SUPPL. O. pp. 50-55.
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