Prevalence and severity of ventricular dysfunction in patients with HIV-related pulmonary arterial hypertension

Objectives: To evaluate the occurrence of ventricular systolic dysfunction in human immunodeficiency virus (HIV)-related pulmonary arterial hypertension (PAH). Background: Patients with HIV-related PAH may develop ventricular systolic dysfunction both as a consequence of PAH progression or of the myocardial involvement from the HIV infection itself. Methods: Cardiac magnetic resonance imaging was applied to measure ejection fraction for the left ventricle and the right ventricle in patients with HIV-related PAH (n=27) and in patients with PAH from other aetiologies (n=115). Results: In HIV-related PAH, ejection fraction values were lower and a higher proportion of patients presented with an advanced stage of ventricular dysfunction (55% vs. 25%; p=0.009). In a multivariate model, PAH related to HIV infection remained independently associated with advanced ventricular dysfunction (p=0.011). Conclusions: Patients with HIV-related PAH have more prevalent and severe ventricular systolic dysfunction compared to patients with PAH from other aetiologies.