Predictors of electrocardiographic QT interval prolongation in men with HIV

Katherine C. Wu*, Long Zhang, Sabina A. Haberlen, Hiroshi Ashikaga, Todd T. Brown, Matthew J. Budoff, Gypsyamber D'Souza, Lawrence A. Kingsley, Frank J. Palella, Joseph B. Margolick, Otoniel Martínez-Maza, Elsayed Z. Soliman, Wendy S. Post

*Corresponding author for this work

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Objective HIV-infected (HIV+) individuals may be at increased risk for sudden arrhythmic cardiac death. Some studies have reported an association between HIV infection and prolongation of the electrocardiographic QT interval, a measure of ventricular repolarisation, which could potentiate ventricular arrhythmias. We aimed to assess whether HIV+ men have longer QT intervals than HIV-uninfected (HIV-) men and to determine factors associated with QT duration. Methods We performed resting 12-lead ECGs in 774 HIV+ and 652 HIV- men in the Multicenter AIDS Cohort Study (MACS). We used multivariable linear and logistic regression analyses to assess associations between HIV serostatus and Framingham corrected QT interval (QTc), after accounting for potential confounders. We also determined associations among QTc interval and HIV-related factors in HIV+ men. In a subgroup of participants, levels of serum markers of inflammation were also assessed. Results After adjusting for demographics and risk factors, QTc was 4.0 ms longer in HIV+ than HIV- men (p<0.001). Use of antiretroviral therapy (ART), specific ART drug class use and other HIV-specific risk factors were not associated with longer QTc. Among the subgroup with inflammatory biomarker measurements, higher interleukin-6 (IL-6), intercellular adhesion molecule-1 (ICAM-1) and B-cell activating factor levels were independently associated with longer QTc and their inclusion partially attenuated the HIV effect. Conclusions HIV+ men had longer QTc, which was associated with higher levels of systemic inflammatory factors. This longer QTc may contribute to the increased risk for sudden arrhythmic cardiac death in some HIV+ individuals.

Original languageEnglish (US)
Pages (from-to)559-565
Number of pages7
JournalHeart
Volume105
Issue number7
DOIs
StatePublished - Apr 1 2019

Keywords

  • cardiac risk factors and prevention
  • electrocardiography
  • inflammatory markers

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Wu, K. C., Zhang, L., Haberlen, S. A., Ashikaga, H., Brown, T. T., Budoff, M. J., D'Souza, G., Kingsley, L. A., Palella, F. J., Margolick, J. B., Martínez-Maza, O., Soliman, E. Z., & Post, W. S. (2019). Predictors of electrocardiographic QT interval prolongation in men with HIV. Heart, 105(7), 559-565. https://doi.org/10.1136/heartjnl-2018-313667