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Abd-Elmoniem KZ, Ishaq H, Purdy J, Matta J, Hamimi A, Hannoush H, Hadigan C, Gharib AM. Association of Coronary Wall Thickening and Diminished Diastolic Function in Asymptomatic, Low Cardiovascular Disease-Risk Persons Living with HIV. Radiol Cardiothorac Imaging 2024; 6:e230102. [PMID: 38573125 PMCID: PMC11056756 DOI: 10.1148/ryct.230102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 12/19/2023] [Accepted: 02/14/2024] [Indexed: 04/05/2024]
Abstract
Purpose To assess early subclinical coronary artery disease (CAD) burden and its relation to myocardial function in asymptomatic persons living with HIV (PLWH) who are at low risk for cardiovascular disease (CVD). Materials and Methods In this prospective, HIPAA-compliant study (ClinicalTrials.gov NCT01656564 and NCT01399385) conducted from April 2010 to May 2013, 74 adult PLWH without known CVD and 25 matched healthy controls underwent coronary MRI to measure coronary vessel wall thickness (VWT) and echocardiography to assess left ventricular function. Univariable and multivariable linear regression analyses were used to evaluate statistical associations. Results For PLWH, the mean age was 49 years ± 11 (SD), and the median Framingham risk score was 3.2 (IQR, 0.5-6.6); for matched healthy controls, the mean age was 46 years ± 8 and Framingham risk score was 2.3 (IQR, 0.6-6.1). PLWH demonstrated significantly greater coronary artery VWT than did controls (1.47 mm ± 0.22 vs 1.34 mm ± 0.18; P = .006) and a higher left ventricular mass index (LVMI) (77 ± 16 vs 70 ± 13; P = .04). Compared with controls, PLWH showed altered association between coronary artery VWT and both E/A (ratio of left ventricular-filling peak blood flow velocity in early diastole [E wave] to that in late diastole [A wave]) (P = .03) and LVMI (P = .04). In the PLWH subgroup analysis, coronary artery VWT increase was associated with lower E/A (P < .001) and higher LVMI (P = .03), indicating restricted diastolic function. In addition, didanosine exposure was associated with increased coronary artery VWT and decreased E/A ratio. Conclusion Asymptomatic low-CVD-risk PLWH demonstrated increased coronary artery VWT in association with impaired diastolic function, which may be amenable to follow-up studies of coronary pathogenesis to identify potential effects on the myocardium and risk modification strategies. Keywords: Coronary Vessel Wall Thickness, Diastolic Function, HIV, MRI, Echocardiography, Atherosclerosis Clinical trial registration nos. NCT01656564 and NCT01399385 Supplemental material is available for this article. © RSNA, 2024.
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Affiliation(s)
- Khaled Z. Abd-Elmoniem
- From the Biomedical and Metabolic Imaging Branch, National Institute
of Diabetes and Digestive and Kidney Diseases (K.Z.A.E., H.I., J.M., A.H.,
A.M.G.), Critical Care Medicine Department, National Institutes of Health
Clinical Center (J.P.), National Human Genome Research Institute (H.H.), and
National Institute of Allergy and Infectious Diseases (C.H.), National
Institutes of Health, 10 Center Dr, Bethesda, MD 20892; and Department of
Radiology, University of Chicago, Chicago, Ill (A.H.)
| | - Hadjira Ishaq
- From the Biomedical and Metabolic Imaging Branch, National Institute
of Diabetes and Digestive and Kidney Diseases (K.Z.A.E., H.I., J.M., A.H.,
A.M.G.), Critical Care Medicine Department, National Institutes of Health
Clinical Center (J.P.), National Human Genome Research Institute (H.H.), and
National Institute of Allergy and Infectious Diseases (C.H.), National
Institutes of Health, 10 Center Dr, Bethesda, MD 20892; and Department of
Radiology, University of Chicago, Chicago, Ill (A.H.)
| | - Julia Purdy
- From the Biomedical and Metabolic Imaging Branch, National Institute
of Diabetes and Digestive and Kidney Diseases (K.Z.A.E., H.I., J.M., A.H.,
A.M.G.), Critical Care Medicine Department, National Institutes of Health
Clinical Center (J.P.), National Human Genome Research Institute (H.H.), and
National Institute of Allergy and Infectious Diseases (C.H.), National
Institutes of Health, 10 Center Dr, Bethesda, MD 20892; and Department of
Radiology, University of Chicago, Chicago, Ill (A.H.)
| | - Jatin Matta
- From the Biomedical and Metabolic Imaging Branch, National Institute
of Diabetes and Digestive and Kidney Diseases (K.Z.A.E., H.I., J.M., A.H.,
A.M.G.), Critical Care Medicine Department, National Institutes of Health
Clinical Center (J.P.), National Human Genome Research Institute (H.H.), and
National Institute of Allergy and Infectious Diseases (C.H.), National
Institutes of Health, 10 Center Dr, Bethesda, MD 20892; and Department of
Radiology, University of Chicago, Chicago, Ill (A.H.)
| | - Ahmed Hamimi
- From the Biomedical and Metabolic Imaging Branch, National Institute
of Diabetes and Digestive and Kidney Diseases (K.Z.A.E., H.I., J.M., A.H.,
A.M.G.), Critical Care Medicine Department, National Institutes of Health
Clinical Center (J.P.), National Human Genome Research Institute (H.H.), and
National Institute of Allergy and Infectious Diseases (C.H.), National
Institutes of Health, 10 Center Dr, Bethesda, MD 20892; and Department of
Radiology, University of Chicago, Chicago, Ill (A.H.)
| | - Hwaida Hannoush
- From the Biomedical and Metabolic Imaging Branch, National Institute
of Diabetes and Digestive and Kidney Diseases (K.Z.A.E., H.I., J.M., A.H.,
A.M.G.), Critical Care Medicine Department, National Institutes of Health
Clinical Center (J.P.), National Human Genome Research Institute (H.H.), and
National Institute of Allergy and Infectious Diseases (C.H.), National
Institutes of Health, 10 Center Dr, Bethesda, MD 20892; and Department of
Radiology, University of Chicago, Chicago, Ill (A.H.)
| | - Colleen Hadigan
- From the Biomedical and Metabolic Imaging Branch, National Institute
of Diabetes and Digestive and Kidney Diseases (K.Z.A.E., H.I., J.M., A.H.,
A.M.G.), Critical Care Medicine Department, National Institutes of Health
Clinical Center (J.P.), National Human Genome Research Institute (H.H.), and
National Institute of Allergy and Infectious Diseases (C.H.), National
Institutes of Health, 10 Center Dr, Bethesda, MD 20892; and Department of
Radiology, University of Chicago, Chicago, Ill (A.H.)
| | - Ahmed M. Gharib
- From the Biomedical and Metabolic Imaging Branch, National Institute
of Diabetes and Digestive and Kidney Diseases (K.Z.A.E., H.I., J.M., A.H.,
A.M.G.), Critical Care Medicine Department, National Institutes of Health
Clinical Center (J.P.), National Human Genome Research Institute (H.H.), and
National Institute of Allergy and Infectious Diseases (C.H.), National
Institutes of Health, 10 Center Dr, Bethesda, MD 20892; and Department of
Radiology, University of Chicago, Chicago, Ill (A.H.)
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Intracoronary Ultrasound Imaging Combined with Traditional Chinese Medicine Nursing Applied in the Treatment of Coronary Heart Disease Patients with Phlegm and Blood Stasis Syndrome. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:2820851. [PMID: 36051920 PMCID: PMC9420650 DOI: 10.1155/2022/2820851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/01/2022] [Accepted: 07/13/2022] [Indexed: 11/17/2022]
Abstract
This study was to explore the effect of traditional Chinese medicine (TCM) nursing intervention based on intracoronary ultrasound imaging on patients with coronary heart disease (CHD) and phlegm and blood stasis syndrome (PBSS). 100 hospitalized patients with CHD with Qi deficiency and blood stasis syndrome (QDBSS) were rolled into the experimental (Exp) group (routine nursing intervention) and control (Ctrl) group (TCM nursing intervention, syndrome differentiation nursing), with 50 patients in each group. They underwent the intracoronary ultrasound imaging scanning. The results showed that after intervention, the plaque load (45.08 ± 6.02%), plaque eccentricity index (0.47 ± 0.08%), vascular remodeling index (0.53 ± 0.11%), and vascular external elastic membrane area (8.67 ± 3.06 mm2) of the Exp group were notably inferior to those of the Ctrl group (60.22 ± 5.82%, 0.59 ± 0.08%, 0.71 ± 0.09%, and 10.56 ± 2.31 mm2). The total effective rate in the Exp group (88%) was greatly superior to that of the Ctrl group (68%). In terms of TCM symptom scores, the TCM symptom scores of chest pain, chest tightness, and shortness of breath in the Exp group after intervention (1.07 ± 0.21 points, 0.75 ± 0.27 points, and 0.58 ± 0.12 points) were notably inferior to those in the Ctrl group (1.62 ± 0.28 points, 1.03 ± 0.21 points, and 0.79 ± 0.14 points). In the Exp group, after intervention, the degree of physical activity limitation (67.05 ± 5.08 points), the stable state of angina pectoris (65.28 ± 3.76 points), the frequency of angina pectoris attack (85.92 ± 2.97 points), the degree of treatment satisfaction (75.39 ± 5.94 points), the cognition score of disease (63.56 ± 5.84 points), the levels of triglyceride (1.27 ± 0.41 mmol/L), and total cholesterol (2.24 ± 0.41 mmol/L) were remarkably inferior to the Ctrl group (52.97 ± 4.31 points, 50.77 ± 4.69 points, 71.36 ± 3.77 points, 64.08 ± 5.64 points, 51.77 ± 6.33 points, 2.09 ± 0.57 mmol/L, and 3.06 ± 0.84 mmol/L) (P < 0.05). It suggested that intracoronary ultrasound imaging can clearly display the coronary plaques of patients and accurately evaluate the clinical efficacy of patients with CHD. The TCM nursing program can greatly improve the angina symptoms and quality of life of patients with CHD and PBSS, reduce blood lipid levels, and effectively improve the clinical efficacy of patients.
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