Immunoglobulins and left ventricular structure and function in pediatric HIV infection

Steven E Lipshultz, E. John Orav, Stephen P. Sanders, Steven D. Colan

Research output: Contribution to journalArticle

69 Citations (Scopus)

Abstract

Background: Progressive left ventricular (LV) dilation is common in children infected with HIV-1 and may be a harbinger of congestive heart failure (CHF). In many HIV-infected children, dilation is associated with inadequate LV hypertrophy, elevated afterload, and reduced LV function. Because CHF has been observed empirically to improve after treatment with intravenous immunoglobulin (IVIG) in other conditions and because LV dysfunction in pediatric HIV may be immunologically mediated, we examined retrospectively the relation between immunoglobulins and LV structure and function in 49 HIV-infected infants and children without CHF. Methods and Results: A total of 106 echocardiograms were performed in these children within 30 days of serum immunoglobulin (IgG, IgA, and IgM) measurements; this includes 12 children treated with IVIG therapy. All echocardiographic parameters, blood pressures, and immunoglobulins were adjusted for age or body surface area and subjected to repeatedmeasures regression. Regression models were adjusted simultaneously for endogenous IgA, IgG, IgM, IVIG therapy. zidovudine therapy, age, HIV disease stage, and weight. Higher endogenous serum IgG levels and IVIG treatment were associated with significantly greater wall thickness and lower peak wall stress. Higher endogenous serum IgA levels were associated with more normal LV wall thickness and LV thickness-to-dimension ratios. LV contractility, fractional shortening, endsystolic wall stress, and thickness-to-dimension ratio all showed a trend toward more normal values with higher endogenous immunoglobulin values or during IVIG treatment. Conclusions: LV structure and function appear to be more normal in HIV-infected children who receive IVIG treatment and in those with higher endogenous IgG levels. These results suggest that both the impaired myocardial growth and the LV dysfunction observed may be immunologically mediated and responsive to immunomodulatory therapy. (Circulation. 1995; 92:2220-2225.).

Original languageEnglish
Pages (from-to)2220-2225
Number of pages6
JournalCirculation
Volume92
Issue number8
StatePublished - Oct 15 1995
Externally publishedYes

Fingerprint

Intravenous Immunoglobulins
Left Ventricular Function
HIV Infections
Immunoglobulins
Pediatrics
HIV
Immunoglobulin G
Immunoglobulin A
Passive Immunization
Heart Failure
Left Ventricular Dysfunction
Immunoglobulin M
Dilatation
Serum
Therapeutics
Immunomodulation
Zidovudine
Body Surface Area
Left Ventricular Hypertrophy
HIV-1

Keywords

  • AIDS
  • Cardiomyopathy
  • Immune system
  • Immunoglobulins
  • Pediatrics

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Lipshultz, S. E., Orav, E. J., Sanders, S. P., & Colan, S. D. (1995). Immunoglobulins and left ventricular structure and function in pediatric HIV infection. Circulation, 92(8), 2220-2225.

Immunoglobulins and left ventricular structure and function in pediatric HIV infection. / Lipshultz, Steven E; Orav, E. John; Sanders, Stephen P.; Colan, Steven D.

In: Circulation, Vol. 92, No. 8, 15.10.1995, p. 2220-2225.

Research output: Contribution to journalArticle

Lipshultz, SE, Orav, EJ, Sanders, SP & Colan, SD 1995, 'Immunoglobulins and left ventricular structure and function in pediatric HIV infection', Circulation, vol. 92, no. 8, pp. 2220-2225.
Lipshultz SE, Orav EJ, Sanders SP, Colan SD. Immunoglobulins and left ventricular structure and function in pediatric HIV infection. Circulation. 1995 Oct 15;92(8):2220-2225.
Lipshultz, Steven E ; Orav, E. John ; Sanders, Stephen P. ; Colan, Steven D. / Immunoglobulins and left ventricular structure and function in pediatric HIV infection. In: Circulation. 1995 ; Vol. 92, No. 8. pp. 2220-2225.
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