Document 0319
 DOCN  M9460319
 TI    Emerging patterns of heart disease in HIV infected homosexual subjects
       with and without opportunistic infections; a prospective colour flow
       Doppler echocardiographic study.
 DT    9408
 AU    Akhras F; Dubrey S; Gazzard B; Noble MI; Academic Medicine, Charing
       Cross and Westminster Medical School,; Chelsea and Westminster Hospital,
       London, U.K.
 SO    Eur Heart J. 1994 Jan;15(1):68-75. Unique Identifier : AIDSLINE
       MED/94229107
 AB    We studied 124 homosexual men aged 36.7 +/- 7.6 years (range 23-57)
       using Doppler echocardiography. One hundred and one patients (Group A)
       had had acquired immunodeficiency syndrome for 1.6 +/- 1.0 years and 23
       patients (Group B) had had HIV infection without opportunistic
       infections for 3.2 +/- 2.3 years. Doppler echocardiography was normal in
       31% of Group A patients and in 61% of Group B. Pericardial effusion was
       found in 44 Group A patients (44%) and two Group B patients (9%). In
       Group A, left ventricular dilatation and/or dysfunction were found in 20
       patients (20%), aortic root dilatation and regurgitation in eight
       patients (8%) and an intracardiac echogenic mass in seven patients (7%);
       in Group B one patient (4%) had an intracardiac mass. Forty-four (44%)
       Group A patients had cardiac presentations, and of these 22 had
       cardiomegaly with clinical signs of heart failure; 10 patients had
       tachyarrhythmias compared to only two in Group B. Although the CD4
       lymphocyte count (%) was significantly lower in Group A than in Group B
       (5.4 +/- 6.1 vs 13.3 +/- 7.3, P < 0.001), the presence of pericardial
       effusion, left ventricular dysfunction, right-sided cardiac enlargement
       or the duration of HIV infection, did not relate to the CD4 level in
       either group. Although often not diagnosed clinically, cardiac
       involvement in patients with AIDS is a clinical reality, with
       pericardial effusion, cardiomyopathy and left ventricular dysfunction
       appearing to have a high prevalence in male homosexual patients with
       AIDS. These clinical and echocardiographic findings are associated with
       clinically apparent intercurrent opportunistic infections, rather than
       the HIV virus per se, or the severity of infection as reflected by the
       CD4 count.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS/EPIDEMIOLOGY  Adult
       AIDS-Related Opportunistic Infections/*COMPLICATIONS/EPIDEMIOLOGY
       Comparative Study  *Echocardiography, Doppler  Heart
       Diseases/*COMPLICATIONS/EPIDEMIOLOGY/*ULTRASONOGRAPHY  *Homosexuality
       Human  HIV Seropositivity/EPIDEMIOLOGY  Male  Pericardial
       Effusion/*COMPLICATIONS/EPIDEMIOLOGY/*ULTRASONOGRAPHY  Prevalence
       Prospective Studies  JOURNAL ARTICLE

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