Left Ventricular Dysfunction Caused by Drug Cardiotoxicity

Studies of transgenic mice suggest that zidovudine is associated with diffuse destruction of cardiac mitochondrial ultra­structure and inhibition of mitochondrial DNA replication [37, 38]. This mitochondrial dysfunction may result in lactic acidosis, which could also contribute to myocardial cell dysfunction. However, in a study of infants born to HIV-positive mothers fol­lowed up from birth to age 5, perinatal expo­sure to zidovudine was not found to be asso­ciated with acute or chronic abnormalities in left ventricular structure or function [39]. Other nucleoside reverse transcriptase inhibitors, such as didanosine and zal- citabine, do not seem to either promote or prevent dilated cardiomyopathy.