A STUDY OF CARDIAC MANIFESTATIONS IN PATIENTS WITH HIV/AIDS

2021 ◽  
Vol 9 (10) ◽  
pp. 411-422
Author(s):  
Ajay Bang ◽  
◽  
Deepti Deshmukh ◽  
Sanjay Raut ◽  
◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Cd4 Count ◽  
Hiv Positive ◽  
X Ray ◽  
Cardiac Abnormalities ◽  
Ventricular Diastolic Dysfunction ◽  
Chest X Ray ◽  
Cardiac Manifestations

Introduction:HIV/AIDS pandemic is evolving as a major public concern. Cardiovascular diseases are common in HIV-positive patients. Many patients without any symptoms or signs were found to have a cardiovascular disease on autopsy.It is expected that the risk of cardiovascular disease willrise in the following years due to the cardiovascular risk profile andincreased life expectancy of infected patients. Therefore,diagnosis andtherapy of HIV-associated cardiovascular diseases should be part of the evaluation and management of the HIV-positive patient. Objectives: To find out the frequency of cardiac manifestations on clinical examination, electrocardiography, chest X-ray, and echocardiographic examination. To assess the association of Cardiac abnormality with CD4 Count in patients with HIV/AIDS. Toevaluate the association between cardiac abnormalities with types and duration of antiretroviral therapy regimen (ART). Method:A total of 100 consecutive patients visiting ART OPD and admitted to our institute were examined for signs and symptoms of cardiovascular disease. All patients were evaluated with electrocardiography, chest X-ray, and 2 D echocardiography. CD4 count was measured for all patients using flowcytometry using a BD FACS Count system. Results:Out of 100 patients, 53% were male and 47% were female. Patients were divided into subgroups with CD4 count <200, 200-349, 350-499, and ≥500. The mean CD4 count was 403.62 ± 284.98. Prevalence of the cardiovascular abnormality on ECG, chest X-ray, and echocardiography were 74%, 10%, and 51% respectively. The left ventricular systolic dysfunction was the most common finding in our study with fractional shortening ≤25% in 34% of patients and LVEF <50% in 27% of patients followed by left ventricular diastolic function (26%), dilated cardiomyopathy (6%), pulmonary hypertension (4%), and regional wall motion abnormality (2%).Reduced LV ejection fraction (<50%) and left ventricular diastolic dysfunction were statistically significant in patients with CD4 count less than 200/mm3. Conclusion: In present study electrocardiographic, chest X-ray and echocardiographic abnormalities were present in 74%, 10% and 51% patients respectively. Cardiac abnormalities such as QTc prolongation, LBBB, reduced left ventricular ejection fraction, and left ventricular diastolic dysfunction were more significantly higher in patients with CD4 count less than 200/mm3. We could not find any statistically significant difference in cardiac abnormalities in patients on different ART regimens. Further studies are required with a higher sample size.

scholarly journals Study on prevalence of left ventricular diastolic dysfunction in chronic obstructive pulmonary disease

2019 ◽  
Vol 6 (2) ◽  
pp. 222
Author(s):  
Mohamed Rafi ◽  
Monna Mohamed Jaber
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Diastolic Dysfunction ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
X Ray ◽  
Copd Patients ◽  
Ventricular Diastolic Dysfunction ◽  
Chest X Ray

Background: Left ventricular diastolic dysfunction (LVD) is very common in chronic obstructive pulmonary disease (COPD) patients. The aim of the present study was to LVD function in COPD patients using echocardiogram and to detect the presence of LVD dysfunction in all stages of COPD.Methods: This was an observational study done at Institute of Internal Medicine, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, during the period from March 2015 to August 2015. The study included 100 patients with COPD. All patients were subjected to chest X-ray, electrocardiogram, pulmonary function test (PFT) and echocardiogram.Results: The results showed the prevalence rate of LVD dysfunction in 80% patients with COPD. There was a good significant correlation between age (p<0.001), status of smoking (p<0.05), chest X-ray findings (p<0.001) and stages of COPD (p<0.001) with incidence of LVD in study population.Conclusions: High prevalence of LVD dysfunction was noticed in patients with COPD. Hence patients with COPD should undergo routine examinations timely to prevent the incidence of associated cardiovascular complications.

scholarly journals Spectrum Of Chest X-Ray Findings Among Human Immunodeficiency Virus Positive Individuals In A Nigerian Tertiary Hospital

2014 ◽  
Vol 10 (2) ◽  
pp. 27-34 ◽  
Author(s):  
Rachael Adeyanju Akinola ◽  
TM Balogun ◽  
AA Adeniyi ◽  
JAA Onakoya ◽  
IO Fabeyibi
Keyword(s):  
Immune System ◽  
Teaching Hospital ◽  
Cd4 Count ◽  
University Teaching ◽  
Hiv Positive ◽  
X Rays ◽  
Cd4 Counts ◽  
X Ray ◽  
Ciency Virus ◽  
Chest X Ray

Introduction: Human immunodefi ciency virus infection damages the immune system making those affected more susceptible to opportunistic infections and malignancies which are common in the chest. This study sought to determine the pattern of chest X-ray lesions and the corresponding CD4 counts of HIV positive patients reporting in the antiretroviral clinic of this teaching hospital for the fi rst time. Methodology: Consecutive HIV positive patients that attended the antiretroviral clinic of the Lagos State University Teaching Hospital, (LASUTH) from September 2009 to January 2011 were recruited. Their chest x-rays were assessed for the presence of pulmonary lesions and baseline CD 4 counts were done to assess their degree of immunosuppression. Data were analyzed using the Statistical Package for Social Sciences, version 16.0. Results: There were 211 subjects, 151 females and 60 males with a M:F ratio of 1:2.5 The mean age of participants was 36.5±11.9. Mean baseline CD4 count for the subjects was 279±220.7 cells/mm3. Almost two thirds (64.9%) cases had normal chest x-rays with their mean CD4 count as 277.65±228.54 cells/mm3. The commonest lesions seen in the lungs include pulmonary infi ltrations, 55 (26.1%), cardiomegaly, 24 (11.4%), pulmonary consolidation, 21 (10%) and lymphadenopathy, 14 (6.6%). The commonest radiological diagnosis made were Atypical pneumonitis, 39 (18.5%), pulmonary TB, 13 (6.2%), pneumonia 13 (6.2%) and cardiomegaly13 (6.2%) respectively.Patients with chest findings had lower mean CD4 counts, 239 cells/mm3 when compared to those without, 244 cells/mm3. Conclusion: Pulmonary infiltration was the commonest lesion, while the commonest diagnosis was atypical pneumonitis. Patients with chest x-ray lesions were found to have lower CD4 counts with probable worse destruction of their immune system. SAARC Journal of Tuberculosis, Lung Diseases & HIV/AIDS; 2013; X(2); 27-34 DOI: http://dx.doi.org/10.3126/saarctb.v10i2.9710

scholarly journals Prevalence and Predictors of Left Ventricular Diastolic Dysfunction in Malaysian Patients With Type 2 Diabetes Mellitus Without Prior Known Cardiovascular Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Kok Han Chee ◽  
Kok Leng Tan ◽  
Ibrahim Luqman ◽  
Shahrizal Shudim Saiful ◽  
Yee Yean Chew ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Diastolic Dysfunction ◽  
Ventricular Dysfunction ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Chinese Ethnicity ◽  
Ventricular Diastolic Dysfunction ◽  
Echocardiographic Assessment

Objective: Existing data showed that left ventricular diastolic dysfunction is common in individuals with type 2 diabetes mellitus (T2DM). However, most of the studies included diabetic patients who have prior cardiovascular disease, which might be the compounding factor for ventricular dysfunction. This study aimed to determine the prevalence and predictors of left ventricular diastolic dysfunction in an Asian population with T2DM without prior cardiovascular disease using the latest recommended echocardiographic assessment for left ventricular diastolic dysfunction.Design and Participants: This is a cross-sectional study in which eligible patients with T2DM without history of coronary artery disease, heart failure, or valvular heart disease were recruited. Demographic data, diabetic control, comorbidities, microvascular/macrovascular complications, and medications prescribed were recorded. Venous blood was sent to test for B-type natriuretic peptide, and transthoracic echocardiography was performed to assess left ventricular dysfunction.Setting: This study was performed in a tertiary healthcare center located in Kuala Lumpur, Malaysia.Results: Of the 301 patients, 83.1% have had T2DM for &gt;10 years, with 45.8% being poorly controlled. Comorbidities include hypertension (77.1%), hyperlipidemia (91.0%), and pre-obesity/obesity (72.9%). Majority had absence of microvascular (albuminuria, retinopathy, and neuropathy) and macrovascular (peripheral vascular disease and stroke) complications. None had raised B-type natriuretic peptide levels, and 93.7% had no symptoms of heart failure. On echocardiographic assessment, 70.1% had left ventricular diastolic dysfunction, and 90.5% had Grade 1/mild severity. Age, ethnicity, insulin therapy, presence of hypertension, and hyperlipidemia were significantly associated with left ventricular diastolic dysfunction. Older T2DM patients of Chinese ethnicity and on insulin are about two times more likely to develop left ventricular diastolic dysfunction.Conclusion: There was a high prevalence of asymptomatic left ventricular diastolic dysfunction among patients with T2DM without prior known cardiovascular disease. Older age, insulin therapy, and Chinese ethnicity were risk factors for left ventricular diastolic dysfunction in T2DM.

scholarly journals Discovery of biomarkers for the presence and progression of left ventricular diastolic dysfunction and HEart faiLure with Preserved ejection Fraction in patients at risk for cardiovascular disease: rationale and design of the HELPFul case-cohort study in a Dutch cardiology outpatient clinic

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e028408 ◽  
Author(s):  
Gideon B Valstar ◽  
Sophie H Bots ◽  
Floor Groepenhoff ◽  
Aisha Gohar ◽  
Frans H Rutten ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Cohort Study ◽  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Outpatient Clinic ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Preserved Ejection Fraction ◽  
Ventricular Diastolic Dysfunction

IntroductionLeft ventricular diastolic dysfunction (LVDD) is a common condition in both sexes that may deteriorate into heart failure (HF) with preserved ejection fraction (pEF), although this seems to happen more often in women than in men. Both LVDD and HFpEF often go unrecognised, necessitating the discovery of biomarkers that aid both the identification of individuals with LVDD at risk of developing HF and identification of individuals most likely to benefit from treatment.Methods and analysisHELPFul is an ongoing case-cohort study at a Dutch cardiology outpatient clinic enrolling patients aged 45 years and older without history of cardiovascular disease, who were referred by the general practitioner for cardiac evaluation. We included a random sample of patients and enriched the cohort with cases (defined as an E/e’ ≥8 measured with echocardiography). Information about medical history, cardiovascular risk factors, electrocardiography, echocardiography, exercise test performance, common carotid intima-media thickness measurement and standard cardiovascular biomarkers was obtained from the routine care data collected by the cardiology outpatient clinic. Study procedure consists of extensive venous blood collection for biobanking and additional standardised questionnaires. Follow-up will consist of standardised questionnaires by mail and linkage to regional and national registries. We will perform cardiac magnetic resonance imaging and coronary CT angiography in a subgroup of patients to investigate the extent of macrovascular and microvascular coronary disease.Ethics and disseminationThe study protocol was approved by the Institutional Review Board of the University Medical Center Utrecht. Results will be disseminated through national and international conferences and in peer-reviewed journals in cardiovascular disease.Trial registrationNTR6016;Pre-results.

scholarly journals Study of Clinical, Laboratory and Radiological Spectrum of Tuberculosis in HIV-Infected Individuals and Its Correlation with CD4 Count

2021 ◽  
Vol 8 (16) ◽  
pp. 1025-1029
Author(s):  
Lavanya Devi Palaniswamy ◽  
Moogaambiga Solai Raja Pandiyan ◽  
Punitha Murugesan
Keyword(s):  
Pulmonary Tuberculosis ◽  
Tuberculin Test ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Sputum Smear ◽  
Cd4 Counts ◽  
X Ray ◽  
Keywords Hiv ◽  
Chest X Ray ◽  
Extra Pulmonary

BACKGROUND Tuberculosis is often more difficult to diagnose and more complicated to treat among people who are human immunodeficiency virus (HIV) positive. This study was conducted to assess the clinical, microbiological, laboratory and radiological spectrum of tuberculosis (TB) in HIV seropositive patients, and explore its possible correlation with their CD4 count. METHODS A total of 104 patients who were western blot positive for HIV and co-infected with tuberculosis were studied in Salem district of Tamil Nadu. A detailed history was obtained and patients were examined clinically. CD4 count, sputum smear for acid fast bacilli (AFB), chest x-ray, and tuberculin test, were done along with other relevant investigations. The relationship between CD4 count, and the type of tuberculosis, sputum smear, chest x-ray, and tuberculin test, were analysed statistically, and P < 0.05 was considered significant. RESULTS Most of the patients were between 30 to 39 years. Males (84.6 %) outnumbered females (15.4 %). Pulmonary tuberculosis alone was seen in 47 patients, while extra pulmonary tuberculosis in 36 cases, and both pulmonary and extra pulmonary occurred in 21 cases. They had a mean CD4 count of 237.7 cells / μL, 135.2 cells / μL and 120.9 cells / μL respectively. Extrapulmonary tuberculosis and combined forms were associated with lower CD4 counts (P-value 0.005). The mean CD4 count of sputum positive, sputum negative, and multiple drug resistant (MDR) tuberculosis were 294.2, 168.3 and 90.2 cells / μL respectively. Lower CD4 count was associated with sputum - ve TB (P < 0.041). Lower CD4 counts were associated with atypical chest X-ray findings (P < 0.006) and negative tuberculin test (P < 0.001). CONCLUSIONS Sputum smear positivity for AFB decreases as CD4 count reduces. Involvement of lungs tend to be atypical in immunocompromised patients. The diagnosis of TB in HIV positive individuals is complex and a high index of suspicion is needed. KEYWORDS HIV, Tuberculosis, CD4 Cell Count, Sputum Smear for AFB, Chest X-Ray

scholarly journals The effect of sex and age hormonal changes on the development of heart failure

2020 ◽  
Vol 25 (6) ◽  
pp. 3710
Author(s):  
E. K. Serezhina ◽  
A. G. Obrezan
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Sex Hormones ◽  
The Elderly ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Progression Rate ◽  
Hormonal Changes ◽  
Ventricular Diastolic Dysfunction ◽  
Relationship Of

Currently, there is an increase in the incidence of cardiac disease in the elderly. Both the morbidity and progression rate differ in different age and sex groups. Agerelated cardiovascular changes can also be associated with the influence of sex hormones both on the myocardium itself and on the signaling involved in the regulation of circulation. Estrogen affects the mechanisms of vasodilation, the relationship of hypoxia and angiogenesis, the development of left ventricular diastolic dysfunction. Therefore, estrogen deficiency is a risk factor for cardiovascular diseases. An increase in the androgen level is involved in pathophysiological mechanisms such as aging, heart failure, and vascular remodeling. Many studies have demonstrated the inverse relationship between sex hormone levels and cardiovascular risk, morbidity and mortality. However, efforts to control the natural hormonal changes show mixed results. Additional prospective studies are needed to clarify the roles of various sex hormones in initiating cardiovascular disease and cardiac failure itself, as well as evaluating the effectiveness of hormone therapy in patients with cardiovascular disease.

Sign in / Sign up

Export Citation Format

Share Document