Cardiovascular manifestations and left ventricular functions in human immunodeficiency virus infection in infants and children in Thailand.

During January through December 1993, twelve symptomatic infants and children (6 females, 6 males) with human immunodeficiency virus infection were prospectively evaluated for their cardiovascular clinical manifestations and ventricular functions, using two-dimensional, M-mode and Doppler echocardiographic examination. From auscultation, the pulmonic component of the second heart sound was accentuated in 8 cases and the murmur of atrioventricula valve regurgitation and pericardial friction rub were audible in 7 and 6 patients, respectively. Cardiomegaly and venous congestion were present on chest roentgenogram in 6 cases and electrocardiogram was abnormal in 5. The echocardiogram demonstrated elevated pulmonary arterial pressure in 9 patients. There were 5 cases of non-tamponade pericardial effusion. Five patients had mitral and pulmonary insufficiency while six had tricuspid insufficiency. The ejection fraction and shortening fraction were increased in all. The incidence of pulmonary hypertension was more frequent than previously reported.

Ventricular functions in children with human immunodeficiency virus infection after ACE-inhibitors.

Nine pediatric symptomatic patients infected with human immunodeficiency virus with elevated pulmonary arterial pressure (MPA pressure) and ejection fraction (EF); and with fractional shortening, (FS) mean velocity of circumferential fiber shortening (MVCfc) and left ventricular peak systolic wall stress (PS) were prospectively evaluated using 2-dimensional and M-mode serial echocardiography and Doppler cardiography after administration of an ACE inhibitor (Inhibace 0.025 mg/kg/D orally) for 12 weeks. The MPA pressure was not decreased, however the MVCfc and PS improved significantly (p < 0.05). Further, long term evaluation is required to determine its effect in preventing dilated cardiomyopathy and elevated mean pulmonary pressure.