Antiretroviral Therapy Highly Active

ABC

Editorial

At Last, a Sensitive Method to Detect Incipient Systolic Dysfunction!

Left ventricular systolic function evaluation has always been one of the main attributions of echocardiography. The degree of ventricular systolic dysfunction is an important predictor of outcome for a large number of diseases, including ischemic heart disease, cardiomyopathy, valvular heart disease, and congenital heart disease. In this area, the ejection fraction has been sovereign for many decades, but despite being a parameter that can, in most cases, inform the real state of global ventricular function, in many situations it may be normal in the presence of evident systolic or diastolic dysfunction.

Known clinical examples are the several cases of heart failure with preserved ejection fraction (HFpEF) or patients with hypertrophic cardiomyopathy, among others. For this reason, an index that can identify early ventricular dysfunction that is not connected with the ejection fraction has been sought for a long time.

[…]

Read Full Article

ABC

Original Article

Subclinical Carotid Atherosclerosis and Reduced DAD Score for Cardiovascular Risk Stratification in HIV-Positive Patients

Achilles Gustavo Silva et al. Rafael Vieira Paulo Mario León Silva-Vergara

Abstract

Background:

HIV-positive patients are twice as likely than the general population to have a heart attack and are four times at greater risk of sudden death. In addition to the increased risk, these individuals present with cardiovascular events on average approximately 10 years earlier than the general population.

Objective:

To compare Framingham and reduced DAD (Data Collection on Adverse Effects of Anti-HIV Drugs Cohort) scores for cardiovascular risk assessment in HIV-positive patients and potential impact on clinical decision after evaluation of subclinical carotid atherosclerosis.

Methods:

Seventy-one HIV-positive patients with no history of cardiovascular disease were clinically evaluated, stratified by the Framingham 2008 and reduced DAD scores and submitted to subclinical carotid atherosclerosis evaluation. Agreement between scores was assessed by Kappa index and p < 0.05 was considered statistically significant.

Results:

mean age was 47.2 and 53.5% among males. The rate of subclinical atherosclerosis was 39.4%. Agreement between scores was 49% with Kappa of 0.735 in high-risk patients. There was no significant difference between scores by ROC curve discrimination analysis. Among patients with intermediate risk and Framingham and reduced DAD scores, 62.5% and 30.8% had carotid atherosclerosis, respectively.

Conclusion:

The present study showed a correlation between the scores and medium-intimal thickening, besides a high correlation between patients classified as high risk by the Framingham 2008 and reduced DAD scores. The high prevalence of carotid atherosclerosis in intermediate risk patients suggests that most of them could be reclassified as high risk.

Read Full Article

ABC

Review Article

Metabolic abnormalities, antiretroviral therapy and cardiovascular disease in elderly patients with HIV

Andréa Sebben Kramer et al. Alexandre Ramos Lazzarotto Eduardo Sprinz Waldomiro Carlos Manfroi

One of the most recent phenomena related to the acquired immunodeficiency syndrome (AIDS) is the emergence of a new vulnerable population: the elderly. One of the factors that account for this increase is the development of combination antiretroviral therapy (ART), which has provided better quality of life and life expectancy for HIV-positive patients. However, ART is associated with adverse effects such as dyslipidemia, diabetes mellitus and insulin resistance, which are risk factors for cardiovascular disease. Due to the impact of ART on lipid and glucose metabolism, many studies were published involving HIV infection and cardiovascular disease, as well as their risk factors and the use of ART, but few of them reported on the cardiotoxicity of this therapy in the elderly. The objective of this study is to review the main metabolic changes caused by the use of antiretroviral therapy and its impact on an increased risk of cardiovascular disease in elderly people with HIV.

Read Full Article

At Last, a Sensitive Method to Detect Incipient Systolic Dysfunction!

Subclinical Carotid Atherosclerosis and Reduced DAD Score for Cardiovascular Risk Stratification in HIV-Positive Patients

Abstract

Background:

Objective:

Methods:

Results:

Conclusion:

Metabolic abnormalities, antiretroviral therapy and cardiovascular disease in elderly patients with HIV

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)

Electronic Document Format (Vancouver)

Electronic Document Format (ABNT)

Electronic Document Format (APA)

Electronic Document Format (ISO)