P353Is possible to determine early stage of right ventricle dysfunction in the patients with acquired immunodeficiency syndrome?


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Abstract

The patient with acquired immunodeficiency syndrome (AIDS) often present the signs and symptoms of impaired left (LV) and right ventricle (RV) function.The aim of this study was to determine RVmorphology and function during AIDS and analyze of relation with the time of infection and initiation of retroviral therapy. Materials and method: We studied 41 patients HIV-positive(+),mean age (42,01±28,3y),28 men,mean time of HIV-infection-6,43±14,7y. The patients had any signs and symptoms of heart failure.We analyze two groups of patients: I-without antiviral therapy (19), II-pts treated with antiviral drugs (22). Mean age was significantly lower in I group (p=.002) and significantly more of men in group I (p=.002). Time of viremia was similar in both groups. Control group was 20 healthy subjects (11men),mean age (40±10,2y). M-mode,2D,PW- and CW-doppler and TDI examination were performed. RV function was assessed by RV diameter,TAPSE (Tricuspid Annulus Systolic Excursion),FAC (Fractional Area Change) and tricuspid annular velocities using 4-ch view.Systolic velocity(S`t),early diastolic velocity (E`t),late diastolic velocity(A`t) and strain(e),strain rate (SR) of medial segment of RV were determined by TDI.Results: RV diastolic area was significantly higher in I comparing with II and control groups. FAC was normal in both groups, but somewhat not significantly lower in I.TAPSE was normal in both groups, without difference. We found no difference in right atrium area. S`t was normal and similar in both groups, without difference with control group.E`t was slightly reduced in I comparing with control group and A`t was higher in II. We observed significantly lower e of RV in I group.SR was significantly higher in the II comparing with I group, but lower that in the control group (NS). This is gentle difference in diastolic regional right ventricle function between these groups. Same difference we found analysing of stage of disease (CD4)+.E`t was significantly lower and A`t was significantly higher in subgroup with CD4<250. Same difference we state for subgroup with longer time of viremia:lower E`t and higher A`t with E`t/A`t<1, mean time of viremia 108,8 months vs E`t/A`t>1, mean time of viremia 58,9months (p=.007). We not found significantly differences of e and SR between these subgroups.Conclusions: 1. Right ventricular diastolic function is slightly reduced during HIV-viremia in the patients without signs and symptoms of heart failure. 2. Tissue Doppler Imaging (TDI) is simple and sensitive tool to assess impaired RV function in patients with acquired immunodeficiency syndrome.

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