Left ventricular systolic function in Nigerian children with human immunodeficiency virus infection

Congenit Heart Dis. 2012 Sep-Oct;7(5):417-22. doi: 10.1111/j.1747-0803.2012.00676.x. Epub 2012 Jun 13.

Abstract

Objective: The objective of this article was to compare the left ventricular (LV) systolic function of human immunodeficiency virus (HIV)-infected children with that of healthy controls, determine the prevalence of LV systolic dysfunction in HIV-infected children, and its association with age, stage of disease, and use of zidovudine.

Study design: This was a comparative cross-sectional descriptive study.

Setting: A University Teaching Hospital in North-Central Nigeria in 2008.

Patients: One hundred fifty HIV-infected children aged 6 weeks-14 years, and an equal number of age- and sex-matched apparently healthy controls.

Outcome measures: Left ventricular internal dimensions in diastole and systole, LV fractional shortening (FS) and ejection fraction (EF). Left ventricular systolic dysfunction was considered present when FS was <28% or EF was <50%.

Results: Mean LV internal dimensions in diastole was similar in subjects and controls (P= .26). Left ventricular internal dimensions in systole was significantly larger in subjects (2.7 cm, 95% confidence interval [CI] 2.6-2.8 cm) than controls (2.4 cm, 95% CI 2.3-2.5 cm) (P < .001). Mean FS of 27.8% (26.8-28.8%) in subjects was significantly reduced compared with 33.7% (33.1-34.3%) in controls (P < .001), as was EF 61.5% (60.7-62.3%) in subjects and 70.5% (69.7-71.3%) in controls (P < .001). Left ventricular systolic dysfunction was detected in 75 (50.0%, 95% CI 41.7-58.3%) subjects and 5 (3.3%, 95% CI 2.2-6.7) controls (P < .001). Subjects with left ventricular systolic dysfunction were significantly older than those without (P < .001) but did not differ significantly from them with respect to zidovudine therapy or stage of disease.

Conclusions: Left ventricular systolic dysfunction is significantly more frequent in HIV-infected children compared with controls. Left ventricular systolic function in HIV-infected children deteriorates with increasing age and should be serially evaluated in them.

MeSH terms

  • Adolescent
  • Age Factors
  • Anti-HIV Agents / therapeutic use
  • Case-Control Studies
  • Chi-Square Distribution
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Disease Progression
  • Echocardiography, Doppler, Pulsed
  • Female
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology*
  • Humans
  • Infant
  • Logistic Models
  • Male
  • Multivariate Analysis
  • Myocardial Contraction
  • Nigeria / epidemiology
  • Prevalence
  • Stroke Volume
  • Systole*
  • Ventricular Dysfunction, Left / diagnostic imaging
  • Ventricular Dysfunction, Left / epidemiology*
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Function, Left*
  • Zidovudine / therapeutic use

Substances

  • Anti-HIV Agents
  • Zidovudine