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Krauz K, Kempiński M, Jańczak P, Momot K, Zarębiński M, Poprawa I, Wojciechowska M. The Role of Epicardial Adipose Tissue in Acute Coronary Syndromes, Post-Infarct Remodeling and Cardiac Regeneration. Int J Mol Sci 2024; 25:3583. [PMID: 38612394 PMCID: PMC11011833 DOI: 10.3390/ijms25073583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/17/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024] Open
Abstract
Epicardial adipose tissue (EAT) is a fat deposit surrounding the heart and located under the visceral layer of the pericardium. Due to its unique features, the contribution of EAT to the pathogenesis of cardiovascular and metabolic disorders is extensively studied. Especially, EAT can be associated with the onset and development of coronary artery disease, myocardial infarction and post-infarct heart failure which all are significant problems for public health. In this article, we focus on the mechanisms of how EAT impacts acute coronary syndromes. Particular emphasis was placed on the role of inflammation and adipokines secreted by EAT. Moreover, we present how EAT affects the remodeling of the heart following myocardial infarction. We further review the role of EAT as a source of stem cells for cardiac regeneration. In addition, we describe the imaging assessment of EAT, its prognostic value, and its correlation with the clinical characteristics of patients.
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Affiliation(s)
- Kamil Krauz
- Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland; (K.K.); (M.K.); (P.J.); (K.M.)
| | - Marcel Kempiński
- Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland; (K.K.); (M.K.); (P.J.); (K.M.)
| | - Paweł Jańczak
- Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland; (K.K.); (M.K.); (P.J.); (K.M.)
| | - Karol Momot
- Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland; (K.K.); (M.K.); (P.J.); (K.M.)
| | - Maciej Zarębiński
- Department of Invasive Cardiology, Independent Public Specialist Western Hospital John Paul II, Lazarski University, Daleka 11, 05-825 Grodzisk Mazowiecki, Poland; (M.Z.); (I.P.)
| | - Izabela Poprawa
- Department of Invasive Cardiology, Independent Public Specialist Western Hospital John Paul II, Lazarski University, Daleka 11, 05-825 Grodzisk Mazowiecki, Poland; (M.Z.); (I.P.)
| | - Małgorzata Wojciechowska
- Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland; (K.K.); (M.K.); (P.J.); (K.M.)
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Heseltine T, Hughes E, Mattew J, Murray S, Ortega-Martorell S, Olier I, Dey D, Lip GYH, Khoo S. The association of epicardial adipose tissue volume and density with coronary calcium in HIV-positive and HIV-negative patients. J Infect 2023; 86:376-384. [PMID: 36801347 DOI: 10.1016/j.jinf.2023.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 01/27/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023]
Abstract
AIMS We sought to assess and compare the association of epicardial adipose tissue (EAT) with cardiovascular disease (CVD) in HIV-positive and HIV-negative groups. METHODS AND RESULTS Using existing clinical databases, we analyzed 700 patients (195 HIV-positive, 505 HIV-negative). CVD was quantified by the presence of coronary calcification from both dedicated cardiac computed tomography (CT) and non-dedicated CT of the thorax. Epicardial adipose tissue (EAT) was quantified using dedicated software. The HIV-positive group had lower mean age (49.2 versus 57.8, p < 0.005), higher proportion of male sex (75.9 % versus 48.1 %, p < 0.005), and lower rates of coronary calcification (29.2 % versus 58.2 %, p < 0.005). Mean EAT volume was also lower in the HIV-positive group (68mm3 versus 118.3mm3, p < 0.005). Multiple linear regression demonstrated EAT volume was associated with hepatosteatosis (HS) in the HIV-positive group but not the HIV-negative group after adjustment for BMI (p < 0.005 versus p = 0.066). In the multivariate analysis, after adjustment for CVD risk factors, age, sex, statin use, and body mass index (BMI), EAT volume and hepatosteatosis were significantly associated with coronary calcification (odds ratio [OR] 1.14, p < 0.005 and OR 3.17, p < 0.005 respectively). In the HIV-negative group, the only significant association with EAT volume after adjustment was total cholesterol (OR 0.75, p = 0.012). CONCLUSIONS We demonstrated a strong and significant independent association of EAT volume and coronary calcium, after adjustment, in HIV-positive group but not in the HIV-negative group. This result hints at differences in the mechanistic drivers of atherosclerosis between HIV-positive and HIV-negative groups.
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Affiliation(s)
- Thomas Heseltine
- Department of Cardiology, Royal Liverpool University Hospital, Liverpool UK; Institute of Translational Medicine, University of Liverpool, Liverpool, UK; Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool UK.
| | - Elen Hughes
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool UK
| | - Jean Mattew
- Department of Cardiology, Royal Liverpool University Hospital, Liverpool UK
| | - Scott Murray
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool UK
| | - Sandra Ortega-Martorell
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool UK; School of Computer Science and Mathematics, Liverpool John Moores University, Liverpool UK
| | - Ivan Olier
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool UK; School of Computer Science and Mathematics, Liverpool John Moores University, Liverpool UK
| | - Damini Dey
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, USA
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool UK
| | - Saye Khoo
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
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Ectopic Fat and Cardiac Health in People with HIV: Serious as a Heart Attack. Curr HIV/AIDS Rep 2022; 19:415-424. [PMID: 35962851 DOI: 10.1007/s11904-022-00620-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW This study aims to summarize knowledge of alterations in adipose tissue distribution among people with HIV (PWH), with a focus on the cardiac depot and how this relates to the known higher risk of cardiovascular disease in this unique population. RECENT FINDINGS Similar to the general population, cardiac fat depots mirror visceral adipose tissue in PWH. However, altered fat distribution, altered fat quality, and higher prevalence of enlarged epicardial adipose tissue depots are associated with increased coronary artery disease among PWH. Adipose tissue disturbances present in PWH ultimately contribute to increased risk of cardiovascular disease beyond traditional risk factors. Future research should aim to understand how regulating adipose tissue quantity and quality can modify cardiovascular risk.
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Tumkosit M, Han WM, Tankittiwat K, Chattranukulchai P, Siwamogsatham S, Apornpong T, Ureaphongsukkit T, Kerr SJ, Boonyaratavej S, Avihingsanon A. Higher epicardial fat in older adults living with HIV with viral suppression and relationship with liver steatosis, coronary calcium and cardiometabolic risks. AIDS 2022; 36:1073-1081. [PMID: 35212667 DOI: 10.1097/qad.0000000000003204] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES HIV infection is associated with ectopic fat deposition, which leads to chronic inflammation and cardiometabolic dysregulation. We assessed the epicardial adipose tissue (EAT) volume and its associated factors among people with HIV (PWH). DESIGN A cross-sectional study. METHODS We conducted a cross-sectional study among PWH aged at least 50 years and age-matched and sex-matched HIV-negative older individuals in Bangkok, Thailand. Participants underwent a noncontrast, cardiac computed tomography (CT) scan to assess coronary artery calcium (CAC) score and EAT between March 2016 and June 2017. Multivariate linear regression analyses were used to investigate HIV-related factors, cardiac and metabolic markers associated with EAT volume. RESULTS Median age was 55 years [interquartile range (IQR) 52-60] and 63% were men. Median duration of antiretroviral therapy (ART) was 16 years with 97% had HIV-1 RNA less than 50 copies/ml and median CD4 + cell count of 617 cells/μl. Median EAT volume was significantly higher in PWH [99 (IQR 75-122) cm 3 ] than HIV-negative individuals [93 (IQR 69-117) cm 3 ], P = 0.022. In adjusted model, factors associated with EAT volume included male sex ( P = 0.045), older age ( P < 0.001), abnormal waist circumference ( P < 0.001) and HOMA-IR ( P = 0.01). In addition, higher CAC score was independently associated with EAT volume. Higher mean EAT volume was seen in PWH with severe liver steatosis than those without steatosis ( P = 0.018). In adjusted PWH-only model, duration of HIV was significantly associated with higher EAT volume ( P = 0.028). CONCLUSION In an aging cohort, PWH had higher EAT volume than HIV-negative controls. EAT was also independently associated with central fat accumulation, insulin resistance, liver steatosis and CAC score.
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Affiliation(s)
- Monravee Tumkosit
- Department of Radiology, Faculty of Medicine, Chulalongkorn University
| | - Win Min Han
- HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
- The Kirby Institute, University of New South Wales, Sydney, Australia
- Center of Excellence in Tuberculosis, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | | | | | | | | | - Stephen J Kerr
- HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
- The Kirby Institute, University of New South Wales, Sydney, Australia
- Biostatistics Excellence Centre
| | | | - Anchalee Avihingsanon
- HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
- Center of Excellence in Tuberculosis, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Cardiovascular computed tomography and HIV: The evolving role of imaging biomarkers in enhanced risk prediction. IMAGING 2021. [DOI: 10.1556/1647.2021.00025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
The treatment of human immunodeficiency virus (HIV) with antiretroviral (ARV) medications has revolutionised the care for these patients. The dramatic increase in life expectancy has brought new challenges in treating diseases of aging in this cohort. Cardiovascular disease (CVD) is now a leading cause of morbidity and mortality with risk matched HIV-positive patients having double the risk of MI compared to HIV-negative patients. This enhanced risk is secondary to the interplay the virus (and accessory proteins), ARV medications and traditional risk factors. The culmination of these factors can lead to a hybrid metabolic syndrome characterised by heightened ectopic fat. Cardiovascular computed tomography (CT) is ideal for quantifying epicardial adipose tissue volumes, hepatosteatosis and cardiovascular disease burden. The CVD risk attributed to disease burden and plaque morphology is well established in general populations but is less clear in HIV populations. The purpose of this review article is to appraise the latest data on CVD development in HIV-positive patients and how the use of cardiovascular CT may be used to enhance risk prediction in this population. This may have important implications on individualised treatment decisions and risk reduction strategies which will improve the care of these patients.
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Bonou M, Kapelios CJ, Protogerou AD, Mavrogeni S, Aggeli C, Markousis-Mavrogenis G, Psichogiou M, Barbetseas J. Cardiac adiposity as a modulator of cardiovascular disease in HIV. HIV Med 2021; 22:879-891. [PMID: 34514685 DOI: 10.1111/hiv.13166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 08/02/2021] [Accepted: 08/13/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND With the number of people living with human immunodeficiency virus (HIV) steadily increasing, cardiovascular disease has emerged as a leading cause of non-HIV related mortality. People living with HIV (PLWH) appear to be at increased risk of coronary artery disease and heart failure (HF), while the underlying mechanism appears to be multifactorial. In the general population, ectopic cardiac adiposity has been highlighted as an important modulator of accelerated coronary artery atherosclerosis, arrhythmogenesis and HF with preserved ejection fraction (HFpEF). Cardiac adiposity is also strongly linked with obesity, especially with visceral adipose tissue accumulation. AIMS This review aims to summarize the possible role of cardiac fat depositions, assessed by imaging modalities,as potential contributors to the increased cardiac morbidity and mortality seen in PLWH, as well as therapeutic targets in the current ART era. MATERIALS & METHODS Review of contemporary literature on this topic. DISCUSSION Despite antiretroviral therapy (ART), PLWH have evidence of persistent, HIV-related systemic inflammation and body fat alterations. Cardiac adiposity can play an additional role in the pathogenesis of cardiovascular disease in the HIV setting. Imaging modalities such as echocardiography, cardiac multidetector computed tomography and cardiac magnetic resonance have demonstrated increased adipose tissue. Studies show that high cardiac fat depots play an additive role in promoting coronary artery atherosclerosis and HFpEF in PLWH. Systemic inflammation due to HIV infection, metabolic adverse effects of ART, adipose alterations in the ageing HIV population, inflammation and immune activation are likely important mechanisms for adipose dysfunction and disproportionately occurrence of ectopic fat depots in the heart among PLWH. CONCLUSIONS High cardiac adiposity seems to plays an additive role in promoting coronary artery atherosclerosis and HFpEF in PLWH. The underlying mechanisms are multiple and warrant further investigation. Improved understanding of the regulating mechanisms that increase cardiovascular risk in HIV infection may give rise to more tailored therapeutic strategies targeting cardiac fat depots.
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Affiliation(s)
- Maria Bonou
- Department of Cardiology, Laiko General Hospital, Athens, Greece
| | - Chris J Kapelios
- Department of Cardiology, Laiko General Hospital, Athens, Greece
| | - Athanase D Protogerou
- Cardiovascular Prevention & Research Unit, Clinic and Laboratory of Pathophysiology, National and Kapodistrian University Athens School of Medicine, Athens, Greece
| | - Sophie Mavrogeni
- Department of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece
| | - Constantina Aggeli
- First Department of Cardiology, Hippokration General Hospital, National and Kapodistrian University Athens School of Medicine, Athens, Greece
| | | | - Mina Psichogiou
- First Department of Internal Medicine, Laiko General Hospital, National and Kapodistrian University Athens School of Medicine, Athens, Greece
| | - John Barbetseas
- Department of Cardiology, Laiko General Hospital, Athens, Greece
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SADOUNI M, DURAND M, BOLDEANU I, DANIELI C, BODSON-CLERMONT P, MANSOUR S, BARIL JG, TROTTIER B, TREMBLAY C, CHARTRAND-LEFEBVRE C. Association of epicardial fat with noncalcified coronary plaque volume and with low attenuation plaque in people with HIV. AIDS 2021; 35:1575-1584. [PMID: 33831908 PMCID: PMC8286299 DOI: 10.1097/qad.0000000000002911] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES People with HIV are exposed to a higher risk of coronary artery disease (CAD) compared with the general population. Epicardial fat may play a unique role in promoting coronary atherosclerosis. We measured epicardial fat in participants living with HIV and controls and investigated its association with coronary plaque volume and low attenuation plaque, a marker of plaque vulnerability. DESIGN This is a cross-sectional study, nested in the Canadian HIV and Aging Cohort Study, a large prospective cohort actively following participants with HIV and controls. Participants with low/intermediate cardiovascular risk without symptoms/history of CAD were invited to undergo cardiac computed tomography (CT). METHODS Volume of epicardial fat, coronary plaque and low attenuation component of the plaque were measured. Association between epicardial fat, coronary plaque volume and low attenuation component was tested using adjusted regression analysis. RESULTS A total of 169 participants with HIV and 81 controls underwent cardiac CT. Participants with HIV had a greater epicardial fat volume compared with controls (P = 0.019). In participants with HIV, epicardial fat volume was positively associated with duration of nonnucleoside reverse transcriptase inhibitors (NNRTI) (β=2.19, P = 0.004). After adjustment for cardiovascular risk factors, epicardial fat volume was positively associated to noncalcified plaque volume [odds ratio (OR) = 1.09, P = 0.028] and to the low-attenuation plaque component portion (β=0.38, P = 0.026). CONCLUSION The association of epicardial fat volume to noncalcified plaque volume and to low attenuation component plaque may suggest a potential mechanism by which epicardial fat could be a silent driver of CAD in the HIV population.
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Affiliation(s)
- Manel SADOUNI
- Centre hospitalier de l’Université de Montréal (CHUM) Research Center, Montreal, Canada
- Université de Montréal, Montreal, Canada
| | - Madeleine DURAND
- Centre hospitalier de l’Université de Montréal (CHUM) Research Center, Montreal, Canada
- Université de Montréal, Montreal, Canada
- Internal Medicine, CHUM, Montreal, Canada
| | | | | | - Paule BODSON-CLERMONT
- Centre hospitalier de l’Université de Montréal (CHUM) Research Center, Montreal, Canada
| | | | - Jean-Guy BARIL
- Centre hospitalier de l’Université de Montréal (CHUM) Research Center, Montreal, Canada
- Université de Montréal, Montreal, Canada
- Medical Clinic Quartier Latin, Montreal, Canada
| | | | - Cécile TREMBLAY
- Centre hospitalier de l’Université de Montréal (CHUM) Research Center, Montreal, Canada
- Université de Montréal, Montreal, Canada
- Microbiology, CHUM, Montreal, Canada
| | - Carl CHARTRAND-LEFEBVRE
- Centre hospitalier de l’Université de Montréal (CHUM) Research Center, Montreal, Canada
- Université de Montréal, Montreal, Canada
- Radiology, CHUM, Montreal, Canada
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Knudsen AD, Krebs-Demmer L, Bjørge NID, Elming MB, Gelpi M, Sigvardsen PE, Lebech AM, Fuchs A, Kühl JT, Køber L, Lundgren J, Nordestgaard BG, Kofoed KF, Nielsen SD. Pericardial Adipose Tissue Volume Is Independently Associated With Human Immunodeficiency Virus Status and Prior Use of Stavudine, Didanosine, or Indinavir. J Infect Dis 2021; 222:54-61. [PMID: 32027374 DOI: 10.1093/infdis/jiaa057] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 02/04/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Increased pericardial adipose tissue is associated with higher risk of cardiovascular disease. We aimed to determine whether human immunodeficiency virus (HIV) status was independently associated with larger pericardial adipose tissue volume and to explore possible HIV-specific risk factors. METHODS Persons with HIV (PWH) were recruited from the Copenhagen Comorbidity in HIV Infection (COCOMO) Study and matched 1:1 on age and sex to uninfected controls. Pericardial adipose tissue volume was measured using cardiac computed tomography. RESULTS A total of 587 PWH and 587 controls were included. Median age was 52 years, and 88% were male. Human immunodeficiency virus status was independently associated with 17 mL (95% confidence interval [CI], 10-23; P < .001) larger pericardial adipose tissue volume. Larger pericardial adipose tissue volume was associated with low CD4+ nadir and prior use of stavudine, didanosine, and indinavir. Among PWH without thymidine analogue or didanosine exposure, time since initiating combination antiretroviral treatment (per 5-year use) was associated with l6 mL (95% CI, -6 to -25; P = .002) lower pericardial adipose tissue volume. CONCLUSIONS Human immunodeficiency virus status was independently associated with larger pericardial adipose tissue volume. Severe immunodeficiency, stavudine, didanosine, and indinavir were associated with larger pericardial adipose tissue volume. Persons with HIV with prior exposure to these drugs may constitute a distinct cardiovascular risk population.
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Affiliation(s)
- Andreas D Knudsen
- Department of Infectious Diseases 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Cardiology, The Heart Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lisanne Krebs-Demmer
- Department of Infectious Diseases 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Natascha I D Bjørge
- Department of Infectious Diseases 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Marie B Elming
- Department of Cardiology, The Heart Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Marco Gelpi
- Department of Infectious Diseases 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Per E Sigvardsen
- Department of Cardiology, The Heart Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anne-Mette Lebech
- Department of Infectious Diseases 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Infectious Diseases, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | - Andreas Fuchs
- Department of Cardiology, The Heart Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jørgen T Kühl
- Department of Cardiology, The Heart Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lars Køber
- Department of Cardiology, The Heart Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jens Lundgren
- CHIP Department of Infectious Diseases 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Børge G Nordestgaard
- The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Klaus F Kofoed
- Department of Cardiology, The Heart Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Radiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Susanne D Nielsen
- Department of Infectious Diseases 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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A Meta-Analysis of Different Types of Cardiac Adipose Tissue in HIV Patients. BIOMED RESEARCH INTERNATIONAL 2020; 2020:8234618. [PMID: 33376740 PMCID: PMC7746457 DOI: 10.1155/2020/8234618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/31/2020] [Accepted: 11/25/2020] [Indexed: 12/15/2022]
Abstract
Background Antiretroviral therapy transformed HIV infection into a chronic disease but accelerated cardiovascular disease (CVD). Both of epicardial adipose tissue (EAT) and pericardial fat (PCF) have close relationships with CVD. The associations between these two cardiac adipose tissue and HIV are unclear. Methods Eligible studies were searched in PubMed, Embase, Web of Science, and Scopus from database inception to March 24, 2020. The summarized standard mean difference (SMD) or weighted mean difference (WMD) with 95% confidence intervals (CIs) was used to assess the association between EAT/PCF and HIV. Subgroup analysis was performed based on EAT types. Trial sequential analysis was conducted to estimate whether the evidence of the results is sufficient. Results In total, 2561 HIV patients and 1767 non-HIV participants were included. Compared to the control group, EAT was significantly higher in the HIV overall group and subgroup with EAT thickness (SMD = 0.59, 95% CI: 0.24-0.95, P = 0.001; SMD = 1.10, 95% CI: 0.41-1.79, P = 0.002); however, the EAT volume and PCF volume were unchanged in the HIV group (SMD = 0.16, 95% CI: -0.07-0.39, P = 0.169; WMD = 10.78, 95% CI: -14.11-35.67, P = 0.396). Trial sequential analysis indicated that the available samples were sufficient in the HIV overall group and subgroup with EAT thickness, and more studies are needed for EAT volume and PCF volume. Conclusions EAT thickness was significantly higher in patients with HIV. The association between EAT/PCF volume and HIV needs more studies to confirm.
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Toribio M, Neilan TG, Awadalla M, Stone LA, Rokicki A, Rivard C, Mulligan CP, Cagliero D, Fourman LT, Stanley TL, Ho JE, Triant VA, Burdo TH, Nelson MD, Szczepaniak LS, Zanni MV. Intramyocardial Triglycerides Among Women With vs Without HIV: Hormonal Correlates and Functional Consequences. J Clin Endocrinol Metab 2019; 104:6090-6100. [PMID: 31393564 PMCID: PMC6954489 DOI: 10.1210/jc.2019-01096] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 08/02/2019] [Indexed: 12/31/2022]
Abstract
CONTEXT Women with HIV (WHIV) on anti-retroviral therapy (ART) are living longer but facing heightened vulnerability to heart failure. OBJECTIVE We investigated metabolic/hormonal/immune parameters relating to diastolic dysfunction-a precursor to heart failure-among WHIV without known cardiovascular disease (CVD). DESIGN AND OUTCOME MEASURES Nineteen ART-treated WHIV and 11 non-HIV-infected women without known CVD enrolled and successfully completed relevant study procedures [cardiac magnetic resonance spectroscopy (MRS) and cardiac MRI]. Groups were matched on age and body mass index. Primary outcome measures included intramyocardial triglyceride content (cardiac MRS) and diastolic function (cardiac MRI). Relationships between intramyocardial triglyceride content and clinical parameters were also assessed. RESULTS Among WHIV (vs non-HIV-infected women), intramyocardial triglyceride content was threefold higher [1.2 (0.4, 3.1) vs 0.4 (0.1, 0.5)%, P = 0.01], and diastolic function was reduced (left atrial passive ejection fraction: 27.2 ± 9.6 vs 35.9 ± 6.4%, P = 0.007). There was a strong inverse relationship between intramyocardial triglyceride content and diastolic function (ρ = -0.62, P = 0.004). Among the whole group, intramyocardial triglyceride content did not relate to chronologic age but did increase across the reproductive aging spectrum (P = 0.02). HIV status and reproductive aging status remained independent predictors of intramyocardial triglyceride content after adjusting for relevant cardiometabolic parameters (overall model R2 = 0.56, P = 0.003; HIV status P = 0.01, reproductive aging status P = 0.02). CONCLUSIONS For asymptomatic WHIV, increased intramyocardial triglyceride content is associated with diastolic dysfunction. Moreover, relationships between intramyocardial triglyceride accumulation and women's reproductive aging are noted.
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Affiliation(s)
- Mabel Toribio
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Tomas G Neilan
- Cardiac MR PET, CT Program, Division of Cardiology, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Magid Awadalla
- Cardiac MR PET, CT Program, Division of Cardiology, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Lauren A Stone
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Adam Rokicki
- Cardiac MR PET, CT Program, Division of Cardiology, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Corinne Rivard
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Connor P Mulligan
- Cardiac MR PET, CT Program, Division of Cardiology, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Diana Cagliero
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Lindsay T Fourman
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Takara L Stanley
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jennifer E Ho
- Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Virginia A Triant
- Division of General Internal Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Division of Infectious Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Tricia H Burdo
- Department of Neuroscience, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania
| | - Michael D Nelson
- Applied Physiology and Advanced Imaging Laboratory, Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
| | | | - Markella V Zanni
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Correspondence and Reprint Requests: Markella V. Zanni, MD, Metabolism Unit, Massachusetts General Hospital, 55 Fruit Street, 5 LON 207, Boston, Massachusetts 02114. E-mail:
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Mosepele M, Botsile E. Role of Noncommunicable Diseases (NCDs) in Resource-Limited Settings (RLS). Curr HIV/AIDS Rep 2019; 15:120-126. [PMID: 29435953 DOI: 10.1007/s11904-018-0381-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW As access to effective antiretroviral therapy (ART) expands globally, a decline in AIDS-related morbidity and mortality has been complicated by rising rates of noncommunicable diseases (NCDs). This review provides a brief description of NCDs and existing gaps on knowledge about NCDs among HIV-infected adults mostly in Africa. RECENT FINDINGS Recent reports show that one in every five persons living with HIV has a chronic illness, predominantly diabetes and/or hypertension, depression, and most of these conditions are either not diagnosed or not being managed. Human papilloma virus-associated anal dysplasia occurs among 70% of HIV-infected women in RLS. Recognizing risk factors for NCDs and providing effective screening and optimal care remains challenging. Research is urgently needed to carefully characterize HIV-associated NCDs in RLS. Such studies should provide a framework for high-priority NCDs that the limited resources can be focused on in these settings.
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Affiliation(s)
- Mosepele Mosepele
- Department of Internal Medicine, Office F4069 Faculty of Medicine, University of Botswana, Gaborone, Botswana.
| | - Elizabeth Botsile
- Department of Internal Medicine, Office F4069 Faculty of Medicine, University of Botswana, Gaborone, Botswana
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