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Open Access Highly Accessed Research article

QTc interval prolongation in HIV-infected patients: a case–control study by 24-hour Holter ECG recording

Alessandra Fiorentini1, Nicola Petrosillo2, Angelo Di Stefano3, Stefania Cicalini2, Laura Borgognoni3, Evangelo Boumis2, Luigi Tubani3 and Pierangelo Chinello2*

Author Affiliations

1 U.O. Geriatria, Ospedale di Montefiascone, via Donatori di sangue, Montefiascone, 01027, Italy

2 Second Infectious Diseases Unit, National Institute for Infectious Diseases “L. Spallanzani”, via Portuense 292, Rome, 00149, Italy

3 Dipartimento di Medicina Clinica, Policlinico, “Umberto I”, UOS Diagnostica Cardiovascolare Internistica Integrata, viale del Policlinico 155, Rome, 00161, Italy

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BMC Cardiovascular Disorders 2012, 12:124  doi:10.1186/1471-2261-12-124

Published: 23 December 2012

Abstract

Background

Aim of the study was to assess QTc interval by a 24-hour ECG recording in a group of HIV-infected individuals with a basal prolonged QTc. The risk factors associated with QTc prolongation and the indices of cardiovascular autonomic control were also evaluated.

Methods

A case–control study was performed using as cases 32 HIV-infected patients with prolonged (>440 msec) QTc interval as assessed by Holter ECG, and as controls 64 HIV-infected subjects with normal QTc interval. Autonomic function was evaluated by heart rate variability analysis during 24-hour recording.

Results

Duration of HIV disease was significantly longer among cases than among controls (p=0.04). Waist/hip ratio was also higher among cases than among controls (p=0.05). Frequency domain analysis showed the absence of physiologic decrease of low frequency (LF) in the night period in both cases and controls. The LF night in cases showed a statistically significant reduction when compared with controls (p=0.007).

Conclusions

In our study group, QTc interval prolongation was associated with a longer duration of HIV infection and with a greater waist/hip ratio. HIV patients with QTc interval prolongation and with a longer duration of HIV infection were more likely to have an impairment of parasympathetic and sympathetic cardiac component.

Keywords:
Cardiac autonomic function; HIV; Holter ECG; QTc interval