{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T13:11:30Z","timestamp":1754399490289,"version":"3.40.5"},"reference-count":78,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,9,12]],"date-time":"2021-09-12T00:00:00Z","timestamp":1631404800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>With the number of people living with human immunodeficiency virus (HIV) steadily increasing, cardiovascular disease has emerged as a leading cause of non\u2010HIV related mortality. People living with HIV (PLWH) appear to be at increased risk of coronary artery disease and heart failure (HF), while the underlying mechanism appears to be multifactorial. In the general population, ectopic cardiac adiposity has been highlighted as an important modulator of accelerated coronary artery atherosclerosis, arrhythmogenesis and HF with preserved ejection fraction (HFpEF). Cardiac adiposity is also strongly linked with obesity, especially with visceral adipose tissue accumulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This review aims to summarize the possible role of cardiac fat depositions, assessed by imaging modalities,as potential contributors to the increased cardiac morbidity and mortality seen in PLWH, as well as therapeutic targets in the current ART era.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials &amp; Methods<\/jats:title><jats:p>Review of contemporary literature on this topic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Despite antiretroviral therapy (ART), PLWH have evidence of persistent, HIV\u2010related systemic inflammation and body fat alterations. Cardiac adiposity can play an additional role in the pathogenesis of cardiovascular disease in the HIV setting. Imaging modalities such as echocardiography, cardiac multidetector computed tomography and cardiac magnetic resonance have demonstrated increased adipose tissue. Studies show that high cardiac fat depots play an additive role in promoting coronary artery atherosclerosis and HFpEF in PLWH. Systemic inflammation due to HIV infection, metabolic adverse effects of ART, adipose alterations in the ageing HIV population, inflammation and immune activation are likely important mechanisms for adipose dysfunction and disproportionately occurrence of ectopic fat depots in the heart among PLWH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>High cardiac adiposity seems to plays an additive role in promoting coronary artery atherosclerosis and HFpEF in PLWH. The underlying mechanisms are multiple and warrant further investigation. Improved understanding of the regulating mechanisms that increase cardiovascular risk in HIV infection may give rise to more tailored therapeutic strategies targeting cardiac fat depots.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.13166","type":"journal-article","created":{"date-parts":[[2021,9,13]],"date-time":"2021-09-13T03:49:32Z","timestamp":1631504972000},"page":"879-891","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Cardiac adiposity as a modulator of cardiovascular disease in HIV"],"prefix":"10.1111","volume":"22","author":[{"given":"Maria","family":"Bonou","sequence":"first","affiliation":[{"name":"Department of Cardiology Laiko General Hospital Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1616-6307","authenticated-orcid":false,"given":"Chris J.","family":"Kapelios","sequence":"additional","affiliation":[{"name":"Department of Cardiology Laiko General Hospital Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Athanase D.","family":"Protogerou","sequence":"additional","affiliation":[{"name":"Cardiovascular Prevention &amp; Research Unit, Clinic and Laboratory of Pathophysiology National and Kapodistrian University Athens School of Medicine Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie","family":"Mavrogeni","sequence":"additional","affiliation":[{"name":"Department of Cardiology Onassis Cardiac Surgery Center Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constantina","family":"Aggeli","sequence":"additional","affiliation":[{"name":"First Department of Cardiology Hippokration General Hospital National and Kapodistrian University Athens School of Medicine Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Markousis\u2010Mavrogenis","sequence":"additional","affiliation":[{"name":"Department of Cardiology Onassis Cardiac Surgery Center Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mina","family":"Psichogiou","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine Laiko General Hospital National and Kapodistrian University Athens School of Medicine Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Barbetseas","sequence":"additional","affiliation":[{"name":"Department of Cardiology Laiko General Hospital Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,9,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000695"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.033369"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2018.12.024"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/1358863X20978702"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2018.10.009"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/HCO.0000000000000513"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10741-017-9644-1"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics11020362"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20092358"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20235989"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.aal2658"},{"key":"e_1_2_9_13_1","article-title":"Twenty\u2010first century advances in multimodality imaging of obesity for care of the cardiovascular patient","author":"Ian J","year":"2020","journal-title":"JACC Cardiovasc Imaging"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcct.2019.03.006"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.117.007372"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-69747-9"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.2008.27358"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2016.10.024"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.11.062"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31114-0"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1148\/ryct.2021200563"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-020-0181-1"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofz414"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz999"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy083"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2010.199"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0169184"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001483"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e3283474b9f"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2012.03.019"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2013.06.059"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiaa057"},{"key":"e_1_2_9_33_1","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1186\/s12968-015-0193-2","article-title":"Increased pericardial fat accumulation is associated with increased intramyocardial lipid content and duration of highly active antiretroviral therapy exposure in patients infected with human immunodeficiency virus: a 3T cardiovascular magnetic resonance feasibility study","volume":"17","author":"Diaz\u2010Zamudio M","year":"2015","journal-title":"J Cardiovasc Magn Reson"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.3851\/IMP3193"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.115.004091"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/8234618"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2017.07.019"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.20411\/pai.v4i1.304"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000116"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2006.12.082"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000002158"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0072066"},{"key":"e_1_2_9_43_1","first-page":"553","article-title":"Epicardial adipose tissue and coronary artery calcium predict incident myocardial infarction and death in HIV\u2010infected patients","volume":"9","author":"Raggi P","year":"2015","journal-title":"J CardiovascComputTomogr."},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2018.08.002"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2019-315346"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.14814\/phy2.13386"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32833c055a"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/5610347"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiaa245"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.001719"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1177\/0300060517708919"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2014.04.024"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiv274"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2019-01096"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2017.03.029"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13103"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13136"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.013104"},{"key":"e_1_2_9_59_1","first-page":"1","article-title":"A double\u2010blind, placebo controlled, randomised trial to assess the effect of liraglutide on ectopic fat accumulation in South Asian type 2 diabetes patients","volume":"18","author":"vanEyk HJ","year":"2019","journal-title":"CardiovascDiabetol."},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-015-0710-y"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.1002\/oby.22798"},{"key":"e_1_2_9_62_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21072641"},{"key":"e_1_2_9_63_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-012-0174-6"},{"key":"e_1_2_9_64_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2012.03.104"},{"key":"e_1_2_9_65_1","doi-asserted-by":"publisher","DOI":"10.1002\/phar.2342"},{"key":"e_1_2_9_66_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32834884e6"},{"key":"e_1_2_9_67_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix178"},{"key":"e_1_2_9_68_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiz118"},{"key":"e_1_2_9_69_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-1588"},{"key":"e_1_2_9_70_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1293.2007.00488.x"},{"key":"e_1_2_9_71_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e328347f3f1"},{"key":"e_1_2_9_72_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-0490"},{"key":"e_1_2_9_73_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis251"},{"key":"e_1_2_9_74_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2018.12.016"},{"key":"e_1_2_9_75_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000478"},{"key":"e_1_2_9_76_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-1531"},{"key":"e_1_2_9_77_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy781"},{"key":"e_1_2_9_78_1","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.118.311807"},{"key":"e_1_2_9_79_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.09.038"}],"container-title":["HIV Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.13166","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hiv.13166","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.13166","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T14:03:04Z","timestamp":1693317784000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hiv.13166"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,12]]},"references-count":78,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2021,11]]}},"alternative-id":["10.1111\/hiv.13166"],"URL":"https:\/\/doi.org\/10.1111\/hiv.13166","archive":["Portico"],"relation":{},"ISSN":["1464-2662","1468-1293"],"issn-type":[{"type":"print","value":"1464-2662"},{"type":"electronic","value":"1468-1293"}],"subject":[],"published":{"date-parts":[[2021,9,12]]},"assertion":[{"value":"2021-05-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}