Conclusion
In conclusion, cardiac involvement and cardiovascular complications are common in HIV-infected patients. As the epidemic progresses and new treatments help increase the long-term survival of affected individuals, cardiovascular complications will become more common.
The spectrum of disease is broad, but myocardial diseases are mainly represented by myocarditis, dilated cardiomyopathy, CAD, and cardiac tumors. The risk of CAD has dramatically increased in these patients. Many HIV-infected patients have dyslipidemia and other cardiovascular risk factors prior to acquiring infection. HIV infection itself and antiretroviral therapy can cause or worsen lipid abnormalities. Increased risk of CAD may be of special concern in the selection of HAART therapy, because differences in potential CAD risk have been reported for different regimens. Functional comprehensive CMR has routine clinical applications in the setting of myocardial ischaemia and infarction. Besides accurate assessment of LV function and cardiac anatomy with cine-CMR, the study of myocardial perfusion permits the detection of microvascular obstruction after MI that carries important prognostic implications. Contrast-enhanced CMR has become the clinical reference method for detection of myocardial viability after MI or in chronic ischemic LV dysfunction. In addition, CMR is also becoming a reference diagnostic tool in suspected myocarditis. The evolution of CMR patterns during the course of myocarditis may be of great interest for the establishment of prognosis especially in patients with initial LV dysfunction, heart failure, or with familial history of cardiomyopathy. Finally, CMR has the unique capability of discriminating between ischemic or nonischemic disease in HIV-infected patients with dilated cardiomyopathy, and providing important prognostic information in this setting.References
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