Document 0128
 DOCN  M9590128
 TI    Autonomic neuropathy and prolongation of QT interval in human
       immunodeficiency virus infection.
 DT    9509
 AU    Villa A; Foresti V; Confalonieri F; Ill Medical Department,
       Fatebenefratelli Hospital, Milan, Italy.
 SO    Clin Auton Res. 1995 Feb;5(1):48-52. Unique Identifier : AIDSLINE
       MED/95299330
 AB    Autonomic neuropathy has been reported in human immunodeficiency virus
       positive (HIV+) patients. Since alterations in cardiac innervation may
       determine QT interval prolongation, this interval was studied in a group
       of HIV+ subjects to evaluate if it is prolonged and to compare this
       measurement with other diagnostic tests for autonomic neuropathy.
       Fifty-seven HIV+ and 23 human immunodeficiency virus negative (HIV-)
       subjects were studied. Autonomic function was tested by noninvasive
       cardiovascular reflex tests, and the QT interval on the
       electrocardiogram was measured at rest, at maximum tachycardia during
       Valsalva manoeuvre, and afterwards at maximum bradycardia. QT intervals
       were corrected for heart rate according to Bazzett's formula (QTc).
       Autonomic neuropathy was found in 37 HIV+ subjects: 25 had moderate
       autonomic neuropathy (HIV+/mAN) and twelve had severe autonomic
       neuropathy (HIV+/sAN). The 23 HIV- and 20 HIV+ (HIV+/AN-) patients did
       not have autonomic neuropathy. QTc intervals were significantly longer
       in HIV+/sAN and HIV+/mAN than in HIV- at rest; in HIV+/sAN than in HIV-
       at maximum tachycardia; in HIV+/sAN and HIV+/mAN than in HIV+, in
       HIV+/sAN and HIV+/mAN than in HIV+/AN- and in HIV+/sAN than in HIV+/mAN
       at maximum bradycardia. QTc was > or = 440 ms in 24 out of 37 (64.8%)
       patients with autonomic neuropathy and in five out of 20 (25%) HIV+/AN-
       patients (sensitivity 65%, specificity 75%). A significant correlation
       was observed between scores of autonomic involvement and QTc interval
       prolongation. This study confirms that the QTc measurement is a reliable
       parameter indicating the presence of autonomic neuropathy. Since QT
       prolongation may determine ventricular arrhythmias, such patients must
       be followed because they may be at increased risk of sudden death.
 DE    Adult  Autonomic Nervous System Diseases/*PHYSIOPATHOLOGY  Female  Human
       HIV Seropositivity/*PHYSIOPATHOLOGY  Long QT Syndrome/*PHYSIOPATHOLOGY
       Male  Middle Age  JOURNAL ARTICLE

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