Heart Diseases, HIV
Conditions
Brief summary
HIV-infection is associated with an increased risk for cardiovascular disease. Especially patients with low CD4+ counts have a higher incidence of structural heart disease. Myocardial T1 relaxation time, as well as T1-derived extracellular volume fraction are relatively new methods for non-invasive myocardial tissue characterization, including diffuse myocardial fibrosis. In our study HIV-patients with high and low CD4+ counts are examined on a 3T MRI scanner (Ingenia 3T, Philips Medical, Best, Netherlands). Scanning protocol includes common SSFP sequences, STIR imaging and LGE \[Late gadolinium enhancement\]. All HIV patients are treated in the HIV outpatient clinic of the hospital's Internal Medicine department and have an unremarkable history of cardiac disease. Patients are recruited from all over Germany. In order to obtain reference values, a subgroup of healthy, age-matched controls is included in this study. Aim of this study is to show differences in T1- and ECV-values in the investigated subgroups. In addition, we also want to create cut-off values for healthy and affected myocardium in asymptomatic HIV-infected patients. This study could show whether myocardial T1 mapping is a potential screening parameter for beginning heart disease as part of an HIV-infection, and whether an application in routine diagnostic is reasonable.
Interventions
None listed
Sponsors
University Hospital, Bonn
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* chronic HIV infection * no known cardiac disease * no cardiovascular risk factors
Exclusion criteria
* contraindications to MRI (e.g. metal implants) * chronic kidney disease
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Native T1 Relaxation Times | Measurement will be performed within 2 weeks after MRI scan | T1 relaxation times will be directly obtained form the T1 maps through ROI analysis. T1 maps will be analyzed using a segmental approach. T1 relaxation times are given in \[ms\]. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Extracellular volume fraction (ECV) | Measurement will be performed within 2 weeks after MRI scan | Hematocrit corrected ECV will be calculated using pre- and post-contrast T1 values for myocardium and blood pool using following formula: ECV= (1⁄T1 myocardium post contrast-1⁄T1 myocadium pre contrast)/(1⁄T1 blood post contrast-1⁄ T1 blood pre contrast) x (1-hematocrit). ECV is given in percentage. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Cardiac function and aortic distensibility | Measurement will be performed within 2 weeks after MRI scan | Cardiac function (left ventricular endsystolic volume (LV-ESV), left ventricular enddiastolic volume (LV-EDV), and left ventricular ejection fraction (LV-EF)) will be determined offline using a dedicated software (ViewForum, Philips Healthcare, Best, The Netherlands). LV-ESV and LV-EDV will be quantified manually by tracing the endocardial borders. LV-EF is given in percentage. LV-ESV and LV-EDV are given in \[ml\]. Aortic Distensibility will be calculated as: Distensibility(10\^-3 mmHg\^-1 )=(Amax-Amin)/Amin x (Sys-Dias),where Amax and Amin represent the maximal and minimal cross-sectional area of the aorta on cine CMR images, and Sys and Dias represent the systolic and diastolic blood pressures (in millimetres of mercury), respectively. |
Countries
Germany
Contacts
Primary ContactJulian A Luetkens, MD
Backup ContactClaas P Naehle, MD
Outcome results
None listed