Association Between Left Ventricular Scar and Ventricular Ectopy in People Living With and Without HIV

People living with HIV (PLWH) have greater risk for arrhythmic sudden death and heart failure than people without HIV (PWOH), though risk identifiers remain understudied. Higher ventricular ectopy (VE) burden reflects increased arrhythmic susceptibility and cardiomyopathy risk. The purpose of this s...

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Bibliographic Details
Published in:JACC. Advances (Online) 2023-12, Vol.2 (10), p.100722, Article 100722
Main Authors: Mustapha, Aishat, Peterson, Tess E., Haberlen, Sabina, Plankey, Michael, Palella, Frank, Piggott, Damani A., Margolick, Joseph B., Post, Wendy S., Wu, Katherine C.
Format: Article
Language:English
Subjects:
CMR-LGE
HIV
myocardial scar
premature ventricular contractions
risk markers
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Summary:People living with HIV (PLWH) have greater risk for arrhythmic sudden death and heart failure than people without HIV (PWOH), though risk identifiers remain understudied. Higher ventricular ectopy (VE) burden reflects increased arrhythmic susceptibility and cardiomyopathy risk. The purpose of this study was to test if myocardial scar measured by late gadolinium-enhancement cardiovascular magnetic resonance (LGE-CMR) associates with VE by ambulatory electrocardiographic monitoring among PLWH and PWOH with risk factors for HIV, and if the association differs by HIV. Participants from 3 cohorts of PLWH and PWOH underwent electrocardiographic monitoring (median wear time 8.3 days) and CMR. Using multivariable regression, we assessed: 1) associations between scar metrics and VE, adjusting for demographics, HIV serostatus, substance use, cardiovascular risk factors, and left ventricular (LV) function/structure; and 2) effect measure modification by HIV. Of 329 participants (median age 55 years, 30% women, 62% PLWH), 109 had LGE (62% PLWH). Ischemic or major nonischemic pattern LGE was associated with high VE burden (adjusted OR: 2.32, P = 0.004) and more PVCs/day (141% higher, P 
ISSN:2772-963X
2772-963X
DOI:10.1016/j.jacadv.2023.100722