Decreased heart rate variability in HIV positive patients receiving antiretroviral therapy: importance of blood glucose and cholesterol.

<h4>Unlabelled</h4>The presence of autonomic dysfunction in HIV patients is largely unknown. Early studies found autonomic dysfunction in patients with AIDS. Antiretroviral combination therapy (ART) has dramatically changed the course of the disease and improved prognosis and decreased m...

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Autores principales:	Gro Askgaard, Ulrik Sloth Kristoffersen, Jesper Mehlsen, Gitte Kronborg, Andreas Kjaer, Anne-Mette Lebech
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/eee65149a031496489ed228c7c452e11
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spelling	oai:doaj.org-article:eee65149a031496489ed228c7c452e112021-11-18T06:52:49ZDecreased heart rate variability in HIV positive patients receiving antiretroviral therapy: importance of blood glucose and cholesterol.1932-620310.1371/journal.pone.0020196https://doaj.org/article/eee65149a031496489ed228c7c452e112011-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21655281/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Unlabelled</h4>The presence of autonomic dysfunction in HIV patients is largely unknown. Early studies found autonomic dysfunction in patients with AIDS. Antiretroviral combination therapy (ART) has dramatically changed the course of the disease and improved prognosis and decreased morbidity.<h4>Aim</h4>To evaluate whether autonomic dysfunction is present in an ART treated HIV population and if so to identify factors of importance.<h4>Methods</h4>HIV patients receiving ART for at least 12 months (n = 97) and an age-matched control group of healthy volunteers (n = 52) were included. All were non-diabetic and had never received medication for hypertension. Following a 10 min resting period a 15 min ECG recording was performed. Heart-rate variability (HRV) analysis was performed in accordance with current guidelines and data reported as mean [interquartile range].<h4>Results</h4>Mean normal-to-normal (NN) and total HRV measured as standard deviation of normal-to-normal (SDNN) was lower in HIV patients compared to controls (905 vs. 982 ms; p<0.001 and 48 vs. 54 ms; p = 0.028, respectively). No differences were found between the groups in parasympathetic activity measured as square root of the mean squared difference of successive NN-intervals (RMSSD) or the percent of differences between adjacent NN intervals greater than 50 ms (pNN50). In the HIV positives, haemoglobin A1c correlated inversely with SDNN, RMSSD and pNN50 (p<0.05). Total cholesterol and LDL-C correlated inversely with RMSSD and pNN50 (p<0.05). Neither HIV duration, HIV-RNA, CD4 cell count nor CD4 nadir correlated with time or phase domain HRV variables.<h4>Conclusions</h4>Moderate autonomic dysfunction is present in HIV positives patients even with suppressed viral load due to ART. The dysfunction is correlated with HbA1c and hypercholesterolemia but not to duration of HIV or whether the patients were receiving protease inhibitors as part of the ART regime.Gro AskgaardUlrik Sloth KristoffersenJesper MehlsenGitte KronborgAndreas KjaerAnne-Mette LebechPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 5, p e20196 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Gro Askgaard Ulrik Sloth Kristoffersen Jesper Mehlsen Gitte Kronborg Andreas Kjaer Anne-Mette Lebech Decreased heart rate variability in HIV positive patients receiving antiretroviral therapy: importance of blood glucose and cholesterol.
description	<h4>Unlabelled</h4>The presence of autonomic dysfunction in HIV patients is largely unknown. Early studies found autonomic dysfunction in patients with AIDS. Antiretroviral combination therapy (ART) has dramatically changed the course of the disease and improved prognosis and decreased morbidity.<h4>Aim</h4>To evaluate whether autonomic dysfunction is present in an ART treated HIV population and if so to identify factors of importance.<h4>Methods</h4>HIV patients receiving ART for at least 12 months (n = 97) and an age-matched control group of healthy volunteers (n = 52) were included. All were non-diabetic and had never received medication for hypertension. Following a 10 min resting period a 15 min ECG recording was performed. Heart-rate variability (HRV) analysis was performed in accordance with current guidelines and data reported as mean [interquartile range].<h4>Results</h4>Mean normal-to-normal (NN) and total HRV measured as standard deviation of normal-to-normal (SDNN) was lower in HIV patients compared to controls (905 vs. 982 ms; p<0.001 and 48 vs. 54 ms; p = 0.028, respectively). No differences were found between the groups in parasympathetic activity measured as square root of the mean squared difference of successive NN-intervals (RMSSD) or the percent of differences between adjacent NN intervals greater than 50 ms (pNN50). In the HIV positives, haemoglobin A1c correlated inversely with SDNN, RMSSD and pNN50 (p<0.05). Total cholesterol and LDL-C correlated inversely with RMSSD and pNN50 (p<0.05). Neither HIV duration, HIV-RNA, CD4 cell count nor CD4 nadir correlated with time or phase domain HRV variables.<h4>Conclusions</h4>Moderate autonomic dysfunction is present in HIV positives patients even with suppressed viral load due to ART. The dysfunction is correlated with HbA1c and hypercholesterolemia but not to duration of HIV or whether the patients were receiving protease inhibitors as part of the ART regime.
format	article
author	Gro Askgaard Ulrik Sloth Kristoffersen Jesper Mehlsen Gitte Kronborg Andreas Kjaer Anne-Mette Lebech
author_facet	Gro Askgaard Ulrik Sloth Kristoffersen Jesper Mehlsen Gitte Kronborg Andreas Kjaer Anne-Mette Lebech
author_sort	Gro Askgaard
title	Decreased heart rate variability in HIV positive patients receiving antiretroviral therapy: importance of blood glucose and cholesterol.
title_short	Decreased heart rate variability in HIV positive patients receiving antiretroviral therapy: importance of blood glucose and cholesterol.
title_full	Decreased heart rate variability in HIV positive patients receiving antiretroviral therapy: importance of blood glucose and cholesterol.
title_fullStr	Decreased heart rate variability in HIV positive patients receiving antiretroviral therapy: importance of blood glucose and cholesterol.
title_full_unstemmed	Decreased heart rate variability in HIV positive patients receiving antiretroviral therapy: importance of blood glucose and cholesterol.
title_sort	decreased heart rate variability in hiv positive patients receiving antiretroviral therapy: importance of blood glucose and cholesterol.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/eee65149a031496489ed228c7c452e11
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Decreased heart rate variability in HIV positive patients receiving antiretroviral therapy: importance of blood glucose and cholesterol.

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