Cardiac Autonomic Function and QT Interval Prolongation in Human Immunodeficiency Virus Patients Treated with Protease Inhibitor
Sarunyu Wattanawongvisith, MD1, Thapanee Roengrit, PhD2, Tananun Tanpaibule, MD3, Teetouch Ananwattanasuk, MD1, Padoemwut Teerawongsakul, MD, MSc1
Affiliation : 1Cardiology Division, Department of Internal Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand, 2Department of Basic Medical Science, Navamindradhiraj University, Bangkok, Thailand, 3Infectious Division, Department of Internal Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
Objective: Protease inhibitors (PIs) may impair cardiac autonomic function and conduction velocity, leading to clinical bradycardia or conduction delays. In patients with human immunodeficiency virus (HIV) receiving PI therapy, changes in 24-hour heart rate variability (HRV) are used to monitor alterations in sympathetic and parasympathetic activity. The present study investigates the differences in 24-hour HRV between patients with HIV receiving antiretroviral therapy (ART) with a PI regimen and without a PI regimen.
Materials and Methods: The authors conducted a cross-sectional analysis of participants with HIV receiving a PI regimen and a non-PI regimen. An electrocardiogram and 24-hour Holter monitoring were performed on each participant. The primary outcome is the comparison of 24-hour HRV parameters between the PI and non-PI groups. The secondary outcomes include the analysis of differences in the minimum, maximum, and mean values of 24-hour heart rate (HR) and corrected QT (QTc) interval.
Results: Thirty eligible participants (average age 44.6 years, 33% female) were enrolled in the present study. Twelve participants received a PI regimen, while 18 received a non-PI regimen. The PI group showed average values of 29.0 for rMSSD, 47.9 for SDNN, and 33.5 for the HRV triangular index. The non-PI group averaged 25.8 for rMSSD, 46.7 for SDNN, and 33.8 for the HRV triangular index. No statistically significant differences existed between the groups in any of these measures. Similarly, no significant differences were found in the 24-hour HR minimum, maximum, or mean, although the PI group tended to have slightly lower values. Interestingly, the QTc interval measures in the PI group (minimum, maximum, and mean) were slightly longer than those in non-PI group, but these differences also did not reach statistical significance.
Conclusion: The authors’ study found no significant differences in 24-hour HRV between HIV-infected participants on PI regimens and those on non-PI regimens
Received 14 May 2024 | Revised 22 September 2024 | Accepted 24 September 2024
Keywords : Antiretroviral therapy; Cardiac autonomic function; HIV; Human immunodeficiency virus (HIV); Heart rate variability; Protease inhibitors
