R01 HL48012 - Steven Lipshultz - Boston Children's Hospital, Boston, MA
The primary aims of this study were: (1) to establish the incidence, clinical spectrum and natural history of cardiac dysautonomia as defined by heart rate spectral analysis in both HIV-infected and noninfected children, and (2) to evaluate the value of heart rate spectral analysis for predicting dysrhythmias and sudden death in infants and children born to HIV-infected mothers.
This grant was supported from 1992 to 1994.
Electrocardiograms from 479 children who were HIV-positive were analyzed and compared to echocardiographic parameters. Patients with significantly depressed ventricular function appeared to display autonomic dysfunction, specifically an increased sympathetic state. The findings are noteworthy in that HIV infection seems to have an opposite effect from that seen in HIV-negative children. The HIV-positive children showed a trend toward higher resting heart rates associated with higher levels of ventricular function and a negative association between heart rate and afterload. With non-HIV-positive children, ventricular function falls with worsening cardiac dysfunction, and cardiac output is maintained by increasing the heart rate; deterioration of ventricular function is associated with a fall in heart rate.