Abstract
Background: Vascular lesions have become more evident in human immunodeficiency virus type 1 (HIV)-infected patients as the result of earlier diagnosis, improved treatment, and longer survival. Aortic root dilation in HIV-infected children has not previously been described. This study was undertaken to determine the prevalence of aortic root dilation in HIV-infected children and to evaluate some of the potential pathogenic mechanisms. Methods: Aortic root measurements were incorporated into the routine echocardiographic surveillance of 280 children of HIV-infected women: an older cohort of 86 HIV-infected children and a neonatal cohort of 50 HIV-infected and 144 HIV-uninfected children. Results: By repeated-measures analyses, mean aortic root measurements were significantly increased in HIV-infected children versus HIV-uninfected children (P values of ≤.04 and ≤.005 at 2 and 5 years of age, respectively, for aortic annulus diameter, sinuses of Valsalva, and sinotubular junction): Heart rate, systolic blood pressure, stroke volume, hemoglobin, and hematocrit were not significantly associated with aortic root size. Left ventricular dilation, increased serum HIV RNA levels, and lower CD4 cell count measurements were associated with aortic root dilation at baseline. Conclusions: Mild and nonprogressive aortic root dilation was seen in children with vertically transmitted HIV infection from 2 to 9 years of age. Aortic root size was not significantly associated with markers for stress-modulated growth; however, aortic root dilation was associated with left ventricular dilation, increased viral load, and lower CD4 cell count in HIV-infected children. As prolonged survival of HIV-infected patients becomes more prevalent, some patients may require long-term follow-up of aortic root size.
| Original language | English |
|---|---|
| Pages (from-to) | 661-670 |
| Number of pages | 10 |
| Journal | American Heart Journal |
| Volume | 141 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 12 2001 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Dilation of the aortic root in children infected with human immunodeficiency virus type 1 : The prospective P 2C 2 HIV multicenter study. / Lai, Wyman W.; Colan, Steven D.; Easley, Kirk A.; Lipshultz, Steven E; Starc, Thomas J.; Bricker, J. Timothy; Kaplan, Samuel.
In: American Heart Journal, Vol. 141, No. 4, 12.04.2001, p. 661-670.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Dilation of the aortic root in children infected with human immunodeficiency virus type 1
T2 - The prospective P 2C 2 HIV multicenter study
AU - Lai, Wyman W.
AU - Colan, Steven D.
AU - Easley, Kirk A.
AU - Lipshultz, Steven E
AU - Starc, Thomas J.
AU - Bricker, J. Timothy
AU - Kaplan, Samuel
PY - 2001/4/12
Y1 - 2001/4/12
N2 - Background: Vascular lesions have become more evident in human immunodeficiency virus type 1 (HIV)-infected patients as the result of earlier diagnosis, improved treatment, and longer survival. Aortic root dilation in HIV-infected children has not previously been described. This study was undertaken to determine the prevalence of aortic root dilation in HIV-infected children and to evaluate some of the potential pathogenic mechanisms. Methods: Aortic root measurements were incorporated into the routine echocardiographic surveillance of 280 children of HIV-infected women: an older cohort of 86 HIV-infected children and a neonatal cohort of 50 HIV-infected and 144 HIV-uninfected children. Results: By repeated-measures analyses, mean aortic root measurements were significantly increased in HIV-infected children versus HIV-uninfected children (P values of ≤.04 and ≤.005 at 2 and 5 years of age, respectively, for aortic annulus diameter, sinuses of Valsalva, and sinotubular junction): Heart rate, systolic blood pressure, stroke volume, hemoglobin, and hematocrit were not significantly associated with aortic root size. Left ventricular dilation, increased serum HIV RNA levels, and lower CD4 cell count measurements were associated with aortic root dilation at baseline. Conclusions: Mild and nonprogressive aortic root dilation was seen in children with vertically transmitted HIV infection from 2 to 9 years of age. Aortic root size was not significantly associated with markers for stress-modulated growth; however, aortic root dilation was associated with left ventricular dilation, increased viral load, and lower CD4 cell count in HIV-infected children. As prolonged survival of HIV-infected patients becomes more prevalent, some patients may require long-term follow-up of aortic root size.
AB - Background: Vascular lesions have become more evident in human immunodeficiency virus type 1 (HIV)-infected patients as the result of earlier diagnosis, improved treatment, and longer survival. Aortic root dilation in HIV-infected children has not previously been described. This study was undertaken to determine the prevalence of aortic root dilation in HIV-infected children and to evaluate some of the potential pathogenic mechanisms. Methods: Aortic root measurements were incorporated into the routine echocardiographic surveillance of 280 children of HIV-infected women: an older cohort of 86 HIV-infected children and a neonatal cohort of 50 HIV-infected and 144 HIV-uninfected children. Results: By repeated-measures analyses, mean aortic root measurements were significantly increased in HIV-infected children versus HIV-uninfected children (P values of ≤.04 and ≤.005 at 2 and 5 years of age, respectively, for aortic annulus diameter, sinuses of Valsalva, and sinotubular junction): Heart rate, systolic blood pressure, stroke volume, hemoglobin, and hematocrit were not significantly associated with aortic root size. Left ventricular dilation, increased serum HIV RNA levels, and lower CD4 cell count measurements were associated with aortic root dilation at baseline. Conclusions: Mild and nonprogressive aortic root dilation was seen in children with vertically transmitted HIV infection from 2 to 9 years of age. Aortic root size was not significantly associated with markers for stress-modulated growth; however, aortic root dilation was associated with left ventricular dilation, increased viral load, and lower CD4 cell count in HIV-infected children. As prolonged survival of HIV-infected patients becomes more prevalent, some patients may require long-term follow-up of aortic root size.
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U2 - 10.1067/mhj.2001.113757
DO - 10.1067/mhj.2001.113757
M3 - Article
C2 - 11275935
AN - SCOPUS:0035094671
VL - 141
SP - 661
EP - 670
JO - American Heart Journal
JF - American Heart Journal
SN - 0002-8703
IS - 4
ER -