# Evaluation of Subclinical Left Ventricular Dysfunction in HIV Patients Receiving Abacavir, Dolutegravir, and Lamivudine Therapy with Novel Tissue Doppler Imaging Techniques

## TL;DR

This study shows that HIV patients on a specific antiretroviral therapy may experience hidden heart function issues detectable by advanced imaging techniques.

## Contribution

The study introduces the use of Tissue Doppler Imaging to detect subclinical heart dysfunction in HIV patients on HAART.

## Key findings

- TDI detected significant ventricular dysfunction in HIV patients on HAART despite normal conventional echocardiography.
- Myocardial performance index increased and isovolumic acceleration decreased in the HAART group.
- HAART duration and CD4 count were strongly correlated with ventricular function changes.

## Abstract

Background/Objectives: Highly active antiretroviral therapy (HAART) effectively suppresses viral load and aids immunological recovery in HIV patients, but may still lead to subclinical myocardial dysfunction. This study assesses left and right ventricular functions in patients on HAART containing abacavir, dolutegravir, and lamivudine using Tissue Doppler Imaging (TDI). Methods: This observational cross-sectional study involved 118 HIV-positive adults on HAART and 80 age- and gender-matched healthy controls. Comprehensive echocardiographic assessments, including TDI, were conducted to evaluate myocardial performance index (MPI) and isovolumic acceleration (IVA). Results: Conventional echocardiographic parameters showed no significant differences; however, TDI indicated significant impairments in ventricular functions in the HAART group, with increased MPI and decreased IVA (p < 0.001). Pulmonary artery pressures were also higher in the HIV group (p = 0.012). There was a strong positive correlation between MPI and HAART duration (r = 0.675, p = 0.002), and a negative correlation with CD4 count (r = −0.545, p = 0.006). Conclusions: TDI reveals significant subclinical ventricular dysfunction in HIV patients on HAART, correlating with therapy duration and immune status. These findings underscore the utility of TDI in detecting myocardial deterioration before clinical symptoms appear.