Cardiovascular disease in HIV infection

Cardiovascular disease has been well documented in patients with Human Immunodeficiency Virus infection, especially after the introduction of highly active antiretroviral therapy. At present, HIV infection is one of the leading causes of acquired cardiovascular disease including heart failure. Some of the changes observed in these patients include left ventricular systolic dysfunction, dilated cardiomyopathy, congestive heart failure, myocarditis, lipodystrophy, dyslipidemia, insulin resistance, accelerated atherosclerosis including myocardial infarction, prothrombotic state, pericardial effusion, pulmonary hypertension, autonomic dysfunction, and malignancy. This article summarizes the main findings in the principal HIV-associated cardiovascular manifestations in order to stimulate its early recognition so helping in early intervention and therapy.

The metabolic syndrome and its cardiovascular manifestations

The metabolic syndrome is one of the most discussed topics in the past 15 years. It is a collection of risk factors that includes insulin resistance, central obesity, arterial hypertension, and atherogenic dyslipidemia. The presence of these risk factors increases the probability of developing diabetes mellitus and cardiovascular disease, increasing coronary and cardiovascular mortality. The prevalence of the metabolic syndrome in the US has increased in the past years due to an increased incidence of obesity and physical inactivity. Diagnosis of the metabolic syndrome can be done with the use of established criteria by the NCEP-ATP III and the WHO. The principal treatment for this condition is to modify life styles, most importantly, diet and exercise. In many cases, this intervention alone is not sufficient to control these risk factors and a more aggressive intervention is required, including drugs directed to each risk factor independently to avoid complications due to the development of cardiovascular disease associated to the syndrome

The cardiomyopathies, a review for the primary physician

The cardiomyopathies constitute a group of diseases with direct involvement of the heart muscle itself, and is a significant cause of morbidity and mortality. The World Health Organization (WHO) and the International Society and Federation of Cardiology (ISFC) have promulgated a classification taking into consideration the etiology and pathophysiology, which includes dilated cardiomyopathy, hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, restrictive cardiomyopathy, and unclassified cardiomyopathies. Over 25 causes are associated with the development of the cardiomyopathies. The classification of the diseases affecting the heart and causing the cardiomyopathies is presented including the highlights of the most important data for diagnosis and management of each one.