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.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.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.doi http://dx.doi.org/10.1097/QAD.0000000000001066
• dc.identifier.issn 0269-9370
• dc.identifier.uri http://hdl.handle.net/10230/35885
• 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.rights.accessRights info:eu-repo/semantics/openAccess
• dc.subject.keyword Antiretroviral therapy
• dc.subject.keyword Fetal heart
• dc.subject.keyword HIV
• dc.subject.keyword Pregnancy
• dc.subject.keyword Zidovudine
• dc.title Zidovudine treatment in HIV-infected pregnant women is associated with fetal cardiac remodelling
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/acceptedVersion