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Zidovudine treatment in HIV-infected pregnant women is associated with fetal cardiac remodelling

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dc.contributor.author García Otero, Laura
dc.contributor.author López, Marta
dc.contributor.author Gómez, Olga
dc.contributor.author Goncé, Ana
dc.contributor.author Bennasar, Mar
dc.contributor.author Martínez, Josep Maria
dc.contributor.author Valenzuela Alcaraz, Brenda
dc.contributor.author Rodriguez López, Mérida
dc.contributor.author Sitges, Marta
dc.contributor.author Loncà, Montserrat
dc.contributor.author Bijnens, Bart
dc.contributor.author Crispi Brillas, Fàtima
dc.contributor.author Gratacós Solsona, Eduard
dc.date.accessioned 2018-11-29T10:23:31Z
dc.date.available 2018-11-29T10:23:31Z
dc.date.issued 2016
dc.identifier.citation García-Otero L, López M, Gomez O, Goncé A, Bennasar M, Martínez JM, Valenzuela-Álcaraz B, Rodriguez-López M, Sitges M, Lonca M, Bijnens B, Crispi F, Gratacos E. Zidovudine treatment in HIV-infected pregnant women is associated with fetal cardiac remodelling. AIDS. 2016;30(9):1393-401. DOI: 10.1097/QAD.0000000000001066
dc.identifier.issn 0269-9370
dc.identifier.uri http://hdl.handle.net/10230/35885
dc.description.abstract Objective: To evaluate the cardiac structure and function of the fetuses of pregnant women with HIV infection on combined antiretroviral treatment (cART) and the HIV-related and nonrelated determinants of abnormal findings. Design: A prospective cohort study including 42-noninfected fetuses from HIV pregnant women on cART and 84 fetuses from non-HIV-infected women. Methods: Fetal echocardiography was performed at 26–32 weeks of pregnancy to assess cardiac structure and function. The impact of maternal and perinatal factors on fetal cardiac remodelling was evaluated by multivariate regression analysis. Results: Fetuses from HIV pregnant women on cART presented larger hearts and pericardial effusion together with thicker myocardial septal walls (mean 3.56 mm (SD 0.88) vs non-HIV mean 2.75 mm (SD 0.77); P = 0.002) and smaller left ventricular cavities (10.81 mm (SD 2.28) vs 12.3 mm (SD 2.54); P = 0.033). Fetuses from HIV women also presented signs of systolic (mitral systolic annular peak velocity 5.85 cm/s (SD 0.77) vs non-HIV 6.25 cm/s (SD 0.97); P = 0.007) and diastolic (isovolumic relaxation time 52 ms (SD 8.91) vs non-HIV 45 ms (SD 7.98); P < 0.001) dysfunction. In the multivariate analysis, maternal treatment with zidovudine was the only factor significantly associated with fetal cardiac changes (P = 0.014). Conclusion: Fetuses from HIV-infected mothers on cART have cardiac remodelling and dysfunction, which might explain the cardiovascular changes described in childhood. Fetal cardiac remodelling was essentially associated with maternal treatment with zidovudine which challenges its use during pregnancy.
dc.description.sponsorship The study was supported by grants from Instituto de Salud Carlos III y Ministerio de Economia y Competitividad (PI12/00851, PI14/00226) cofinanciado por el Fondo Europeo de Desarrollo Regional de la Unión Europea ‘Una manera de hacer Europa’, Spain; Obra Social la Caixa; Cerebra Foundation for the Brain Injured Children, Carmarthen Wales, UK. L.G.-O was supported by a grant (Premi Emili Letang 2014) from Hospital Clinic, Barcelona, Spain.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Lippincott Williams & Wilkins
dc.relation.ispartof AIDS. 2016;30(9):1393-401.
dc.rights © Lippincott Williams & Wilkins "This is a non-final version of an article published in final form in García-Otero L, López M, Gomez O, Goncé A, Bennasar M, Martínez JM, Valenzuela-Álcaraz B, Rodriguez-López M, Sitges M, Lonca M, Bijnens B, Crispi F, Gratacos E. Zidovudine treatment in HIV-infected pregnant women is associated with fetal cardiac remodelling. AIDS. 2016; 30(9):1393-401". http://dx.doi.org/10.1097/QAD.0000000000001066
dc.title Zidovudine treatment in HIV-infected pregnant women is associated with fetal cardiac remodelling
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1097/QAD.0000000000001066
dc.subject.keyword Antiretroviral therapy
dc.subject.keyword Fetal heart
dc.subject.keyword HIV
dc.subject.keyword Pregnancy
dc.subject.keyword Zidovudine
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/acceptedVersion

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