Characteristics and abnormal rate of electrocardiogram in patients with human immunodeficiency virus/acquired immunodeficiency syndrome
10.3760/cma.j.issn.1000-6680.2019.12.006
- VernacularTitle: 人类免疫缺陷病毒/艾滋病患者心电图特征和异常率分析
- Author:
Xiaoqing HE
1
;
Yinzhong SHEN
1
;
Fengru LU
1
;
Fang SHEN
2
;
Xinian LIU
2
;
Shuwen WANG
3
Author Information
1. Department of Infection and Immunity, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
2. Department of Functional Examination, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
3. Department of Medical Examination Center, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
- Publication Type:Journal Article
- Keywords:
Electrocardiography;
Human immunodeficiency virus;
Acquired immunodeficiency syndrome;
Influencing factors;
CD4 lymphocyte count;
CD8 lymphocyte count
- From:
Chinese Journal of Infectious Diseases
2019;37(12):748-753
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the characteristics and abnormalities of electrocardiograms (ECG) in patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), and to provide evidences for the prevention and treatment of cardiovascular diseases in HIV/AIDS patients.
Methods:The ECG results of 1 131 HIV/AIDS patients and 5 622 non-HIV/AIDS subjects from Shanghai Public Health Clinical Center were involved. The abnormality rates and characteristics of ECG were compared between the two groups. CD4+ T lymphocyte counts, CD8+ T lymphocyte counts and CD4/CD8 ratios were measured in HIV/AIDS patients. The comparison between two groups was conducted by chi-square test. Logistic regression model was used to explore the factors associated with ECG abnormalities in HIV/AIDS patients.
Results:There were 611 cases (54.02%) out of 1 131 HIV/AIDS patients with abnormal ECG. The common abnormal ECG types were sinus tachycardia 239 cases (39.12%), sinus rhythm with ST-T changes 115 cases (18.82%) and sinus bradycardia 55 cases (9.00%). There were 1 958 cases (34.83%) out of 5 622 cases of non-HIV/AIDS subjects with abnormal ECG. The common ECG abnormality types were sinus bradycardia 633 cases (32.33%), sinus rhythm with ST-T changes 463 cases (23.65%) and sinus arrhythmia 256 cases (13.07%). The abnormal rate of ECG in HIV/AIDS patients was significantly higher than that in non-HIV/AIDS subjects (χ2=140.39, P<0.01). The abnormal rates of ECG in HIV/AIDS patients <50 years old and ≥50 years old were both higher than those of non-HIV/AIDS subjects in the corresponding age group, and the differences were statistically significant (χ2=111.92 and 52.12, respectively, both P<0.01). Logistic regression analysis showed an increased risk of abnormal ECG in HIV-infected individuals compared with non-HIV/AIDS individuals (odds ratio (OR)=2.27, 95% confidence interval (CI) 2.00-2.60, P<0.01). The risk of ECG abnormality increased in patients aged ≥50 years(OR=1.60, 95%CI 1.45-1.77, P<0.01). The ECG abnormal distribution patterns were significantly different between different levels of CD4+ T lymphocyte counts, CD8+ T lymphocyte counts and CD4/CD8 ratios in HIV/AIDS patients (χ2= 12.92, 10.99 and 16.48, respectively, all P<0.05 ). The risk of ECG abnormality increased in HIV/AIDS patients aged ≥50 years (OR=1.50, 95%CI 1.15-1.96, P<0.01). When CD8+ T lymphocyte counts ≥500/μL, the risk of ECG abnormalities reduced (OR=0.75, 95%CI 0.58-0.96, P<0.01).
Conclusions:The abnormal rate of ECG in patients with HIV/AIDS is high. The sinus tachycardia and sinus rhythm with ST-T segment changes are common. The risk of ECG abnormality increases in HIV/AIDS patients aged ≥50 years old and reduces when the CD8+ T lymphocyte counts ≥500/μL. Type distribution of ECG abnormalities is associated with cellular immune status of patients.
