Antiretroviral Therapy and HIV-Associated Cardiovascular Disease: A Prospective Cardiac Biomarker and CMR Tissue Characterization Study
Authors' conclusion
Our cardiac biomarker data support the presence of subclinical myocardial injury, remodelling, and fibrosis at HIV diagnosis, and ART had a positive influence on these blood markers.
Study context
- Population
- Newly diagnosed, antiretroviral therapy (ART)-naïve people living with human immunodeficiency virus (HIV)
- Participants
- 73 vs 22
- Exposure
- Newly diagnosed ART-naïve PLWH vs HIV-uninfected controls; PLWH re-evaluated after 9 months of ART
- PLWHn = 73
- Controlsn = 22reference
- Outcome
- Cardiac biomarkers (hs-cTnT, NT-proBNP, sST2, galectin-3) and their correlation with CMR parameters
Methodological detailsage-matched and sex-matched controls, CMR with multiparametric mapping
- Age-matched and sex-matched controls
- CMR with multiparametric mapping
Main finding
As reported in the abstract
Cardiac biomarkers at HIV diagnosis
| Group | High-sensitivity cardiac troponin T (hs-cTnT) | NT-proBNP | Galectin-3 |
|---|---|---|---|
| ART-naïve | 5.1 ng/L | 40.8 ng/L | 9.0 ng/mL |
| Controls | 4.0 ng/L | 23.2 ng/L | 6.8 ng/mL |
High-sensitivity cardiac troponin T (hs-cTnT)
ART-naïve5.1 ng/L
Controls4.0 ng/L
NT-proBNP
ART-naïve40.8 ng/L
Controls23.2 ng/L
Galectin-3
ART-naïve9.0 ng/mL
Controls6.8 ng/mL
- ART-naïve vs Controls: P = 0.004 — hs-cTnT significantly higher in ART-naïve
- ART-naïve vs Controls: P = 0.02 — NT-proBNP significantly higher in ART-naïve
- ART-naïve vs Controls: P = 0.002 — galectin-3 significantly higher in ART-naïve
Observational data: associations, not effects.
Further findings
Change in cardiac biomarkers after ART (ART-naïve vs after ART) · 9 months of ART
- hs-cTnT decreased significantly: 5.1 vs. 4.3 ng/L
- P = 0.02
- NT-proBNP decreased significantly: 40.8 vs. 28.5 ng/L
- P = 0.03
- Soluble ST2 (sST2) trend of decrease: 16.5 vs. 14.8 ng/L
- P = 0.08
- Galectin-3 no decrease: 9.0 vs. 8.8 ng/mL
- P = 0.6
Correlation of biomarkers with CMR native T1, T2 and extracellular volume
- NT-proBNP rs ≥ 0.4
- P < 0.001
- Galectin-3 rs ≥ 0.3
- P < 0.01
Original publication
Antiretroviral Therapy and HIV-Associated Cardiovascular Disease: A Prospective Cardiac Biomarker and CMR Tissue Characterization Study. ESC Heart Fail. Published 15 December 2023. doi:10.
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