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Little ventricular dysfunction evident in HIV patients
  NEW YORK (Reuters Health) - No major left ventricular dysfunction was observed in a small Danish study of HIV-infected patients, most of whom were receiving highly active antiretroviral therapy (HAART), according to researchers. Nevertheless, a number had "modestly reduced" right ventricular function.
As lead investigator Dr. Anne-Mette Lebech told Reuters Health, "in contrast to what has previously been believed, HIV-related heart failure does not seem to be a major problem."
Previous studies have reported a substantial incidence of cardiac dysfunction in HIV patients, Dr. Lebech of Rigshospitalet, Copenhagen and colleagues note in the March issue of the American Heart Journal. However, most of these studies are from the pre-HAART era and may no longer reflect the "dramatic reduction in the rates of HIV-associated morbidity in the developed world."
To investigate, the researchers studied 95 HIV-infected patients and 35 sex- and age-matched controls. Eighty patients were receiving HAART and the mean duration of HIV infection was 104 months.
Radionuclide ventriculography showed that one patient had reduced left ventricular ejection fraction and six had reduced right ventricular ejection fraction.
The mechanisms behind the isolated right ventricular dysfunction in this small but "significant" part of this population, and their importance, the researchers conclude, need to be established.
They also point out that cardiac function was measured at rest, and that studies during exercise might "have detected latent dysfunction."
Nevertheless, Dr. Lebech concluded that "on basis of our findings, routine monitoring of cardiac function [in HIV-infected patients] seems unnecessary."
Am Heart J 2004;147:482-488.

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