Copyright © 1988 by the European Society of Cardiology.
© 1988 The European Society of Cardiology
Echocardiography detects myocardial damage in AIDS: prospective study in 102 patients
Division of Cardiology
*Clinic of Infectious Disease
C.N.R. Department of Pathology, University Hospital L. Sacco Via G. B. Grassi 74, 20157, Milan, Italy
Received 21 August 1987; revised 19 January 1988; .
Address for correspondence: Salvatore Corallo, M.D., Via Plutarco 4, 20145 Milano, Italy.
Abstract
Few date are available about cardiac involvement in AIDS. We examined 102 consecutive patients with AIDS diagnosed clinically and serologically (Walter Reed Stage 5 and 6), by means to TM and cross-sectional echocardiography with the aim of detecting cardiac abnormalities. None of the patients had overt clinical signs of heart failure. Fifty-five (54%) patients showed persistent tachycardia, diminished left ventricular (LV) wall thickness (mean 7.6±0.2 mm) and decreased percentage LV fractional shortening (27±5). In 42 (41%) there was a globular and poorly contracting LV. Thirty-nine (38%) patients had pericardial effusion which was moderate in 30 and small in nine. In four patients, valvular endocarditic vegetation was shown—on the tricuspid valve in three, on the aortic valve in one: all of them were drug addicts; in three (2.9%) patients a cardiac mass was found which proved to be a localization of Kaposi's sarcoma in two. Twenty-five (24.5%) patients died; necropsy showed cardiac dilation, and thin LV walls in 18. On microscopic examination, myocardial fibrosis and lymphocyte infiltration with cell necrosis were observed.
We conclude that cardiac abnormalities are common in AIDS. Impairment in LV contractility as assessed from fractional shortening appears to be the most common echocardiographic finding, followed by LV wall thinning, pericardial effusion and eventually by LV cavity dilation. This evolution is suggestive of myocardial damage and supports the hypothesis that dilated cardiomyopathy may be a cardiac complications of AIDS.
Key Words: Acquired immunodeficiency syndrome(AIDS) • echocardiography, cardiomyopathy.
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