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4 results on '"Krebs-Demmer L"'

2. Cardiac chamber volumes and left ventricular mass in people living with HIV and matched uninfected controls

Author

Krebs-Demmer, L, Ronit, A, Sigvardsen, P E, Lebech, A-M, Gerstoft, J, Knudsen, A D, Fuchs, A, Kühl, J T, Nordestgaard, B G, Kofoed, K F, Nielsen, S D, Krebs-Demmer, L, Ronit, A, Sigvardsen, P E, Lebech, A-M, Gerstoft, J, Knudsen, A D, Fuchs, A, Kühl, J T, Nordestgaard, B G, Kofoed, K F, and Nielsen, S D

Abstract

OBJECTIVES: People living with HIV (PLWH) have increased risk of cardiovascular diseases compared with uninfected populations. We assessed structural cardiac abnormalities and their associated risk factors in well-treated PLWH and uninfected controls using multidetector computed tomography (MDCT).METHODS: People living with HIV and age- and sex-matched uninfected controls underwent MDCT to determine left atrial volume (LAV), left ventricular diastolic volume (LVDV), right ventricular diastolic volume (RVDV) and left ventricular mass (LVM). All outcomes were indexed to body surface area (BSA) (LAVi, LVDVi, RVDVi and LVMi).RESULTS: A total of 592 PLWH and 1184 uninfected controls were included in the study. PLWH had smaller mean (SD) LAVi [40 (8) vs. 41 (9) mL/m2 ; P = 0.002] and LVDVi [61 (13) vs. 65 (14) mL/m2 ; P < 0.001] but larger RVDVi [89 (18) vs. 86 (17) mL/m2 ; P < 0.001] than uninfected controls. HIV was independently associated with 7 mL (95% CI: -10 to -3) smaller LVDV, and with 12 mL (95% CI: 8-16) larger RVDV, and 4 g (95% CI: 1-6) larger LVM after adjustment for cardiovascular risk factors and BSA. Large RVDV in PLWH was not associated with obstructive lung function.CONCLUSIONS: HIV was independently associated with smaller LVDV and larger RVDV and LVM. Alterations in cardiac chamber volumes in PLWH were mainly minor. The clinical impact of these findings is uncertain, but it seems unlikely that alterations in cardiac chamber volumes explain the increased burden of cardiovascular disease previously observed in PLWH.

Published
2020

4. Pericardial Adipose Tissue Volume Is Independently Associated With Human Immunodeficiency Virus Status and Prior Use of Stavudine, Didanosine, or Indinavir.

Author

Knudsen AD, Krebs-Demmer L, Bjørge NID, Elming MB, Gelpi M, Sigvardsen PE, Lebech AM, Fuchs A, Kühl JT, Køber L, Lundgren J, Nordestgaard BG, Kofoed KF, and Nielsen SD

Subjects
Adipose Tissue physiopathology, Adult, Cardiovascular Diseases physiopathology, Denmark, Didanosine adverse effects, Female, HIV Infections physiopathology, HIV Protease Inhibitors therapeutic use, Healthy Volunteers, Humans, Indinavir adverse effects, Male, Middle Aged, Risk Factors, Stavudine adverse effects, Adipose Tissue drug effects, Anti-HIV Agents adverse effects, Anti-HIV Agents therapeutic use, Cardiovascular Diseases chemically induced, HIV Infections drug therapy, Pericardium physiopathology, Viral Load
Abstract

Background: Increased pericardial adipose tissue is associated with higher risk of cardiovascular disease. We aimed to determine whether human immunodeficiency virus (HIV) status was independently associated with larger pericardial adipose tissue volume and to explore possible HIV-specific risk factors., Methods: Persons with HIV (PWH) were recruited from the Copenhagen Comorbidity in HIV Infection (COCOMO) Study and matched 1:1 on age and sex to uninfected controls. Pericardial adipose tissue volume was measured using cardiac computed tomography., Results: A total of 587 PWH and 587 controls were included. Median age was 52 years, and 88% were male. Human immunodeficiency virus status was independently associated with 17 mL (95% confidence interval [CI], 10-23; P < .001) larger pericardial adipose tissue volume. Larger pericardial adipose tissue volume was associated with low CD4+ nadir and prior use of stavudine, didanosine, and indinavir. Among PWH without thymidine analogue or didanosine exposure, time since initiating combination antiretroviral treatment (per 5-year use) was associated with l6 mL (95% CI, -6 to -25; P = .002) lower pericardial adipose tissue volume., Conclusions: Human immunodeficiency virus status was independently associated with larger pericardial adipose tissue volume. Severe immunodeficiency, stavudine, didanosine, and indinavir were associated with larger pericardial adipose tissue volume. Persons with HIV with prior exposure to these drugs may constitute a distinct cardiovascular risk population., (© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)

Published
2020
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