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Contributions of Pulmonary Hypertension to HIV-related Cardiac Dysfunction

G. Isiguzo

B. Okeahialm

S. Danbauchi

A. Odili

M. Iroezindu

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Conference: 2012 International PHA Conference and Scientific Sessions

Release Date: 06.22.2012

Presentation Type: Abstracts

Isiguzo G1, Okeahialm B1, Danbauchi S2, Odili A3, Iroezindu M4

1 Jos University Teaching Hospital, Jos Nigeria

2 Ahmadu Bello Teaching Hospital Zaria, Nigeria

3 University of Abuja Teaching Hospital, Abuja Nigeria

4 University of Nigeria Teaching Hospital, Enugu, Nigeria.

AIM/BACKGROUND: To evaluate the prevalence of pulmonary hypertension among patients living with HIV/AIDS and to determine its contribution to cardiac dysfunction. This study was as a result of our observation that HIV infected patients who are referred for cardiac dysfunction had poorer response to therapy as well as poor outcome if they had pulmonary hypertension

METHOD/RESULTS: A hospital based cross sectional study carried out over a 6 months period. The subjects were 200 consenting confirmed HIV positive patients, 18 years and above being followed up at AIDS Preventive Initiative in Nigeria (APIN Plus) Centre , Jos University Teaching Hospital. There were 71% females (142), mean age 38 ±9 years (range 20 to 65 years). Female subjects were younger, mean age 36 ± 8 years versus 41 ±10 years for males (p-value <0.01). The median CD4 cell count was 312 cells/mm3, there were no homosexual or intravenous drug user among the subjects. Case prevalence of pulmonary hypertension was 4%, with no relationship to CD4 cell count. Both systolic and diastolic functions were worse in subjects with pulmonary hypertension, with a negative correlation between mean pulmonary arterial systolic pressure (mPASP) and parameters like ejection fraction (r= -0.28, p-value 0.0003), fractional shortening (r= -0.21, p-value 0.003), deceleration time (r= -0.13. p-value 0.09).

CONCLUSION: Degree of immune-suppression affects the cardiac function adversely and coexisting pulmonary hypertension contributes to poor systolic and diastolic function as well as worsen prognosis in affected patients. The subtle nature of presentation of both cardiac dysfunction and pulmonary hypertension in HIV/AIDS patients demands a high index of suspicion and early intervention if detected, to ensure better care for these emerging threats to our patients.