Abstract 16972: Patients With Human Immunodeficiency Virus Treated With Highly Active Antiretroviral Therapy Have Increased Intra-Myocardial Triglyceride Accumulation by 3-Tesla Cardiac Magnetic Resonance Spectroscopy
Introduction: Approximately 34 million people worldwide are living with HIV disease, and 55,000 new HIV infections occur annually in the U.S. alone. Highly-active anti-retroviral therapy (HAART) for HIV infection is associated with metabolic abnormalities including dyslipidemia, hyperglycemia, and increased risk of cardiovascular disease. We hypothesized that HIV patients on HAART would have increased intra-myocardial triglyceride accumulation, which may be associated with myocyte lipotoxicity and future risk of cardiac disease.
Methods: This prospective study examined 18 HIV+ subjects and 18 HIV(-) age-matched controls. Inclusion criteria included males 35-55 years of age on HAART for ≥ 3 years; exclusion criteria included known cardiovascular disease, smoking/drug history, diabetes, or prior AIDS-defining illnesses. We compared both groups in regards to medical history, physical exam and laboratory findings, and presence of intra-myocardial triglyceride accumulation on 3-Tesla cardiac magnetic resonance spectroscopy.
Results: There was no difference in age (48.7±4.8 vs. 49.4±3.9 years, p=0.66) or body mass index (25.2±4.0 vs. 24.5±3.8 kg/m2, p=0.59) between cases and controls. Patients with HIV vs controls had increased prevalence of external lipoaccumulation (72% vs. 11%, p<0.001) and lipoatrophy (33% vs. 11%, p=0.04). There was a significant difference in mean intra-myocardial triglyceride fat/water ratio (see figure) between HIV+ and HIV- patients (0.91 ±1.14 vs. 0.27±0.29, p=0.04). On linear regression, intra-myocardial triglyceride content was not independently associated with duration of HIV diagnosis (p=0.45) or duration of HAART therapy (p=0.42).
Conclusion: Patients on HAART have significantly increased intra-myocardial triglyceride content. Further investigation is needed to determine whether this marker of myocyte lipotoxicity is associated with increased risk of future cardiovascular disease in this population.
- © 2013 by American Heart Association, Inc.