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HIV-Associated Myocardial Diastolic Dysfunction and Soluble ST2 Concentration in Tanzanian Adults: A Cross-Sectional Study.

OBJECTIVES
1) To compare the prevalence of myocardial diastolic dysfunction (DD) in ART-naïve people living with HIV (PLWH) to HIV-uninfected adults in East Africa and 2) to determine the association between serum concentration of the cardiac biomarker ST2 and DD.


METHODS/STUDY POPULATION
In this cross-sectional study we enrolled PLWH and uninfected adults at a referral HIV clinic in Mwanza, Tanzania. Standardized history, echocardiography and serum were obtained. Regression models were used to quantify associations.


RESULTS
We enrolled 388 ART-naïve PLWH and 461 HIV-uninfected adults with average age of 36.0+-10.2 years. Of PLWH in the third, fourth and fifth decades of life, 5.0%, 12.5% and 32.7% had DD, respectively. PLWH had a higher prevalence of DD (aOR=2.71[1.62-4.55], p<0.0001). PLWH also had a higher probability of dysfunction with one or fewer traditional risk factors present. Serum ST2 concentration was associated with dysfunction in PLWH but not uninfected participants (p=0.04 and 0.90).


CONCLUSION
In a large population of young adults in sub-Saharan Africa, DD prevalence increased starting in the third decade of life. HIV was independently associated with dysfunction. Serum ST2 concentration was associated with DD in PLWH but not HIV-uninfected participants. This pathway may provide insight into the mechanisms of HIV-associated dysfunction.