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Subclinical Atherosclerosis Imaging in People Living with HIV
In many, but not all studies, people living with HIV (PLWH) have an increased risk of coronary artery disease (CAD) events compared to the general population. This has generated considerable interest in the early, non-invasive detection of asymptomatic (subclinical) atherosclerosis in PLWH. Ultrasou...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723163/ https://www.ncbi.nlm.nih.gov/pubmed/31362391 http://dx.doi.org/10.3390/jcm8081125 |
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author | Schoepf, Isabella C. Buechel, Ronny R. Kovari, Helen Hammoud, Dima A. Tarr, Philip E. |
author_facet | Schoepf, Isabella C. Buechel, Ronny R. Kovari, Helen Hammoud, Dima A. Tarr, Philip E. |
author_sort | Schoepf, Isabella C. |
collection | PubMed |
description | In many, but not all studies, people living with HIV (PLWH) have an increased risk of coronary artery disease (CAD) events compared to the general population. This has generated considerable interest in the early, non-invasive detection of asymptomatic (subclinical) atherosclerosis in PLWH. Ultrasound studies assessing carotid artery intima-media thickness (CIMT) have tended to show a somewhat greater thickness in HIV+ compared to HIV−, likely due to an increased prevalence of cardiovascular (CV) risk factors in PLWH. Coronary artery calcification (CAC) determination by non-contrast computed tomography (CT) seems promising to predict CV events but is limited to the detection of calcified plaque. Coronary CT angiography (CCTA) detects calcified and non-calcified plaque and predicts CAD better than either CAC or CIMT. A normal CCTA predicts survival free of CV events over a very long time-span. Research imaging techniques, including black-blood magnetic resonance imaging of the vessel wall and 18F-fluorodeoxyglucose positron emission tomography for the assessment of arterial inflammation have provided insights into the prevalence of HIV-vasculopathy and associated risk factors, but their clinical applicability remains limited. Therefore, CCTA currently appears as the most promising cardiac imaging modality in PLWH for the evaluation of suspected CAD, particularly in patients <50 years, in whom most atherosclerotic coronary lesions are non-calcified. |
format | Online Article Text |
id | pubmed-6723163 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-67231632019-09-10 Subclinical Atherosclerosis Imaging in People Living with HIV Schoepf, Isabella C. Buechel, Ronny R. Kovari, Helen Hammoud, Dima A. Tarr, Philip E. J Clin Med Review In many, but not all studies, people living with HIV (PLWH) have an increased risk of coronary artery disease (CAD) events compared to the general population. This has generated considerable interest in the early, non-invasive detection of asymptomatic (subclinical) atherosclerosis in PLWH. Ultrasound studies assessing carotid artery intima-media thickness (CIMT) have tended to show a somewhat greater thickness in HIV+ compared to HIV−, likely due to an increased prevalence of cardiovascular (CV) risk factors in PLWH. Coronary artery calcification (CAC) determination by non-contrast computed tomography (CT) seems promising to predict CV events but is limited to the detection of calcified plaque. Coronary CT angiography (CCTA) detects calcified and non-calcified plaque and predicts CAD better than either CAC or CIMT. A normal CCTA predicts survival free of CV events over a very long time-span. Research imaging techniques, including black-blood magnetic resonance imaging of the vessel wall and 18F-fluorodeoxyglucose positron emission tomography for the assessment of arterial inflammation have provided insights into the prevalence of HIV-vasculopathy and associated risk factors, but their clinical applicability remains limited. Therefore, CCTA currently appears as the most promising cardiac imaging modality in PLWH for the evaluation of suspected CAD, particularly in patients <50 years, in whom most atherosclerotic coronary lesions are non-calcified. MDPI 2019-07-29 /pmc/articles/PMC6723163/ /pubmed/31362391 http://dx.doi.org/10.3390/jcm8081125 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Schoepf, Isabella C. Buechel, Ronny R. Kovari, Helen Hammoud, Dima A. Tarr, Philip E. Subclinical Atherosclerosis Imaging in People Living with HIV |
title | Subclinical Atherosclerosis Imaging in People Living with HIV |
title_full | Subclinical Atherosclerosis Imaging in People Living with HIV |
title_fullStr | Subclinical Atherosclerosis Imaging in People Living with HIV |
title_full_unstemmed | Subclinical Atherosclerosis Imaging in People Living with HIV |
title_short | Subclinical Atherosclerosis Imaging in People Living with HIV |
title_sort | subclinical atherosclerosis imaging in people living with hiv |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723163/ https://www.ncbi.nlm.nih.gov/pubmed/31362391 http://dx.doi.org/10.3390/jcm8081125 |
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