Multi-Parametric Diagnostic Approach and Potential Markers of Early Onset Subclinical Cardiovascular Disease in a Cohort of Children, Adolescents and Young Adults Vertically Infected with HIV on cART
Background: HIV infection and lifelong cART are responsible of an increase in cardiovascular risk. The aim of this study was to describe the subclinical cardiovascular disease and to identify early markers of cardiovascular damage in adolescents and young adults vertically infected with HIV on cART,...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/22/5455 |
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| author | Biagio Castaldi Gloria Lanzoni Osvalda Rampon Daniele Donà Angela Di Candia Ornella Milanesi Carlo Giaquinto Giovanni Di Salvo |
| author_facet | Biagio Castaldi Gloria Lanzoni Osvalda Rampon Daniele Donà Angela Di Candia Ornella Milanesi Carlo Giaquinto Giovanni Di Salvo |
| author_sort | Biagio Castaldi |
| collection | DOAJ |
| description | Background: HIV infection and lifelong cART are responsible of an increase in cardiovascular risk. The aim of this study was to describe the subclinical cardiovascular disease and to identify early markers of cardiovascular damage in adolescents and young adults vertically infected with HIV on cART, through an innovative multi-parametric approach. Methods: We enrolled 52 patients vertically infected with HIV. Demographic records, traditional cardiovascular risk factors, laboratory findings and echocardiographic measurements were collected in a one-year routine follow up. The echocardiographic examination included measurements of the 2D and 3D ejection fraction (EF), E/A ratio, E/E′ ratio, carotid intima media thickness (cIMT), flow-mediated dilation (FMD) and global longitudinal strain (GLS). Results: At the time of enrolment, all the patients were on cART therapy. The viral load was suppressed in 95% of them. EF was normal in 94.2% of patients (66 ± 7.2%), and GLS (mean value: −20.0 ± 2.5%) was reduced in 29% of patients. The cIMT mean value was higher than the 95th centile for sex and age in 73%, and FMD was impaired in 45% of patients. Clinically evident disease was found in three patients: dilative cardiomyopathy in one, thoracic-abdominal aneurysm Crawford type II with a bilateral carotid dilation in one and carotid plaque with 30% of stenosis in a third patient. Conclusions: This study confirms the presence of clinical and subclinical cardiovascular disease in a very young population vertically infected with HIV, underlining the importance of an early, multi-parametric cardiovascular follow up. |
| first_indexed | 2024-03-10T05:23:58Z |
| format | Article |
| id | doaj.art-b36971235bc24b5d9ce5468231d3dc82 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T05:23:58Z |
| publishDate | 2021-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-b36971235bc24b5d9ce5468231d3dc822023-11-22T23:51:40ZengMDPI AGJournal of Clinical Medicine2077-03832021-11-011022545510.3390/jcm10225455Multi-Parametric Diagnostic Approach and Potential Markers of Early Onset Subclinical Cardiovascular Disease in a Cohort of Children, Adolescents and Young Adults Vertically Infected with HIV on cARTBiagio Castaldi0Gloria Lanzoni1Osvalda Rampon2Daniele Donà3Angela Di Candia4Ornella Milanesi5Carlo Giaquinto6Giovanni Di Salvo7Department of Women’s and Children’s Health, University of Padua, 35126 Padua, ItalyDepartment of Women’s and Children’s Health, University of Padua, 35126 Padua, ItalyDepartment of Women’s and Children’s Health, University of Padua, 35126 Padua, ItalyDepartment of Women’s and Children’s Health, University of Padua, 35126 Padua, ItalyDepartment of Women’s and Children’s Health, University of Padua, 35126 Padua, ItalyDepartment of Women’s and Children’s Health, University of Padua, 35126 Padua, ItalyDepartment of Women’s and Children’s Health, University of Padua, 35126 Padua, ItalyDepartment of Women’s and Children’s Health, University of Padua, 35126 Padua, ItalyBackground: HIV infection and lifelong cART are responsible of an increase in cardiovascular risk. The aim of this study was to describe the subclinical cardiovascular disease and to identify early markers of cardiovascular damage in adolescents and young adults vertically infected with HIV on cART, through an innovative multi-parametric approach. Methods: We enrolled 52 patients vertically infected with HIV. Demographic records, traditional cardiovascular risk factors, laboratory findings and echocardiographic measurements were collected in a one-year routine follow up. The echocardiographic examination included measurements of the 2D and 3D ejection fraction (EF), E/A ratio, E/E′ ratio, carotid intima media thickness (cIMT), flow-mediated dilation (FMD) and global longitudinal strain (GLS). Results: At the time of enrolment, all the patients were on cART therapy. The viral load was suppressed in 95% of them. EF was normal in 94.2% of patients (66 ± 7.2%), and GLS (mean value: −20.0 ± 2.5%) was reduced in 29% of patients. The cIMT mean value was higher than the 95th centile for sex and age in 73%, and FMD was impaired in 45% of patients. Clinically evident disease was found in three patients: dilative cardiomyopathy in one, thoracic-abdominal aneurysm Crawford type II with a bilateral carotid dilation in one and carotid plaque with 30% of stenosis in a third patient. Conclusions: This study confirms the presence of clinical and subclinical cardiovascular disease in a very young population vertically infected with HIV, underlining the importance of an early, multi-parametric cardiovascular follow up.https://www.mdpi.com/2077-0383/10/22/5455HIVadolescentscardiovascular riskechocardiographyearly-onset cardiovascular disease |
| spellingShingle | Biagio Castaldi Gloria Lanzoni Osvalda Rampon Daniele Donà Angela Di Candia Ornella Milanesi Carlo Giaquinto Giovanni Di Salvo Multi-Parametric Diagnostic Approach and Potential Markers of Early Onset Subclinical Cardiovascular Disease in a Cohort of Children, Adolescents and Young Adults Vertically Infected with HIV on cART Journal of Clinical Medicine HIV adolescents cardiovascular risk echocardiography early-onset cardiovascular disease |
| title | Multi-Parametric Diagnostic Approach and Potential Markers of Early Onset Subclinical Cardiovascular Disease in a Cohort of Children, Adolescents and Young Adults Vertically Infected with HIV on cART |
| title_full | Multi-Parametric Diagnostic Approach and Potential Markers of Early Onset Subclinical Cardiovascular Disease in a Cohort of Children, Adolescents and Young Adults Vertically Infected with HIV on cART |
| title_fullStr | Multi-Parametric Diagnostic Approach and Potential Markers of Early Onset Subclinical Cardiovascular Disease in a Cohort of Children, Adolescents and Young Adults Vertically Infected with HIV on cART |
| title_full_unstemmed | Multi-Parametric Diagnostic Approach and Potential Markers of Early Onset Subclinical Cardiovascular Disease in a Cohort of Children, Adolescents and Young Adults Vertically Infected with HIV on cART |
| title_short | Multi-Parametric Diagnostic Approach and Potential Markers of Early Onset Subclinical Cardiovascular Disease in a Cohort of Children, Adolescents and Young Adults Vertically Infected with HIV on cART |
| title_sort | multi parametric diagnostic approach and potential markers of early onset subclinical cardiovascular disease in a cohort of children adolescents and young adults vertically infected with hiv on cart |
| topic | HIV adolescents cardiovascular risk echocardiography early-onset cardiovascular disease |
| url | https://www.mdpi.com/2077-0383/10/22/5455 |
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