Antiretroviral therapy (ART) has dramatically increased longevity among human immunodeficiency virus (HIV)-infected individuals; consequently, HIV prevalence is increasing.1-7 Cardiovascular disease (CVD) is increasingly common in this growing and aging HIV-infected population, and these individuals appear to have significantly greater risks for myocardial infarction (MI), heart failure, arrhythmias, and sudden cardiac death than the general population.8-19 Unfortunately, few data exist to guide CVD risk stratification, prevention, and care for HIV patients.20-23 Furthermore, HIV-infected persons appear to have greater levels of inflammation, endothelial dysfunction, atherosclerosis, myocardial fibrosis, and ventricular dysfunction than uninfected individuals.24-38 However, few of these studies assessed clinical CVD outcomes and risk profiles predisposing to these dysfunctional CVD states are unclear. Particularly concerning is the lack of investigation into factors contributing to HIV-associated myocardial fibrosis, a potential final common pathway for atherosclerotic and myocardial disease resulting in adverse CVD outcomes in this population. In this application, I propose a comprehensive research and training plan focused on identifying CVD risk profiles and outcomes associated with myocardial disease for HIV-infected persons, which will provide me with essential skills for my development into an independent investigator capable of leading diagnostic and therapeutic studies aimed at curbing HIV-associated CVD.
|Effective start/end date||7/1/16 → 6/30/21|
- American Heart Association (16FTF31200010)