{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T00:52:18Z","timestamp":1794271938204,"version":"4.9.0"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2000,9,26]]},"abstract":"<jats:p>\n            <jats:italic>Background<\/jats:italic>\n            \u2014Left ventricular (LV) dysfunction is common in children infected with the human immunodeficiency virus (HIV), but its clinical importance is unclear. Our objective was to determine whether abnormalities of LV structure and function independently predict all-cause mortality in HIV-infected children.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods and Results<\/jats:italic>\n            \u2014Baseline echocardiograms were obtained on 193 children with vertically transmitted HIV infection (median age, 2.1 years). Children were followed up for a median of 5 years. Cox regression was used to identify measures of LV structure and function predictive of mortality after adjustment for other important demographic and baseline clinical risk factors. The time course of cardiac variables before mortality was also examined. The 5-year cumulative survival was 64%. Mortality was higher in children who, at baseline, had depressed LV fractional shortening (FS) or contractility; increased LV dimension, thickness, mass, or wall stress; or increased heart rate or blood pressure (\n            <jats:italic>P<\/jats:italic>\n            \u22640.02 for each). Decreased LV FS (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.001) and increased wall thickness (\n            <jats:italic>P<\/jats:italic>\n            =0.004) were also predictive of increased mortality after adjustment for CD4 count (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.001), clinical center (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.001), and encephalopathy (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.001). FS showed abnormalities for up to 3 years before death, whereas wall thickness identified a population at risk only 18 to 24 months before death.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            \u2014Depressed LV FS and increased wall thickness are risk factors for mortality in HIV-infected children independent of depressed CD4 cell count and neurological disease. FS may be useful as a long-term predictor and wall thickness as a short-term predictor of mortality.\n          <\/jats:p>","DOI":"10.1161\/01.cir.102.13.1542","type":"journal-article","created":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T00:42:29Z","timestamp":1339461749000},"page":"1542-1548","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":112,"title":["Cardiac Dysfunction and Mortality in HIV-Infected Children"],"prefix":"10.1161","volume":"102","author":[{"given":"Steven E.","family":"Lipshultz","sequence":"first","affiliation":[{"name":"From the Division of Pediatric Cardiology (S.E.L.), University of Rochester Medical Center and Children\u2019s Hospital at Strong and Department of Pediatrics (S.E.L.), University of Rochester School of Medicine and Dentistry, Rochester, NY; Department of Cardiology (S.E.L., S.D.C.), Children\u2019s Hospital, Department of Pediatrics, Harvard Medical School (S.E.L., S.D.C.), Department of Pediatrics, Boston Medical Center and Boston University School of Medicine (S.E.L.), and Department of Medicine, Brigham..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirk A.","family":"Easley","sequence":"additional","affiliation":[{"name":"From the Division of Pediatric Cardiology (S.E.L.), University of Rochester Medical Center and Children\u2019s Hospital at Strong and Department of Pediatrics (S.E.L.), University of Rochester School of Medicine and Dentistry, Rochester, NY; Department of Cardiology (S.E.L., S.D.C.), Children\u2019s Hospital, Department of Pediatrics, Harvard Medical School (S.E.L., S.D.C.), Department of Pediatrics, Boston Medical Center and Boston University School of Medicine (S.E.L.), and Department of Medicine, Brigham..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. John","family":"Orav","sequence":"additional","affiliation":[{"name":"From the Division of Pediatric Cardiology (S.E.L.), University of Rochester Medical Center and Children\u2019s Hospital at Strong and Department of Pediatrics (S.E.L.), University of Rochester School of Medicine and Dentistry, Rochester, NY; Department of Cardiology (S.E.L., S.D.C.), Children\u2019s Hospital, Department of Pediatrics, Harvard Medical School (S.E.L., S.D.C.), Department of Pediatrics, Boston Medical Center and Boston University School of Medicine (S.E.L.), and Department of Medicine, Brigham..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Kaplan","sequence":"additional","affiliation":[{"name":"From the Division of Pediatric Cardiology (S.E.L.), University of Rochester Medical Center and Children\u2019s Hospital at Strong and Department of Pediatrics (S.E.L.), University of Rochester School of Medicine and Dentistry, Rochester, NY; Department of Cardiology (S.E.L., S.D.C.), Children\u2019s Hospital, Department of Pediatrics, Harvard Medical School (S.E.L., S.D.C.), Department of Pediatrics, Boston Medical Center and Boston University School of Medicine (S.E.L.), and Department of Medicine, Brigham..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J.","family":"Starc","sequence":"additional","affiliation":[{"name":"From the Division of Pediatric Cardiology (S.E.L.), University of Rochester Medical Center and Children\u2019s Hospital at Strong and Department of Pediatrics (S.E.L.), University of Rochester School of Medicine and Dentistry, Rochester, NY; Department of Cardiology (S.E.L., S.D.C.), Children\u2019s Hospital, Department of Pediatrics, Harvard Medical School (S.E.L., S.D.C.), Department of Pediatrics, Boston Medical Center and Boston University School of Medicine (S.E.L.), and Department of Medicine, Brigham..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Timothy","family":"Bricker","sequence":"additional","affiliation":[{"name":"From the Division of Pediatric Cardiology (S.E.L.), University of Rochester Medical Center and Children\u2019s Hospital at Strong and Department of Pediatrics (S.E.L.), University of Rochester School of Medicine and Dentistry, Rochester, NY; Department of Cardiology (S.E.L., S.D.C.), Children\u2019s Hospital, Department of Pediatrics, Harvard Medical School (S.E.L., S.D.C.), Department of Pediatrics, Boston Medical Center and Boston University School of Medicine (S.E.L.), and Department of Medicine, Brigham..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wyman W.","family":"Lai","sequence":"additional","affiliation":[{"name":"From the Division of Pediatric Cardiology (S.E.L.), University of Rochester Medical Center and Children\u2019s Hospital at Strong and Department of Pediatrics (S.E.L.), University of Rochester School of Medicine and Dentistry, Rochester, NY; Department of Cardiology (S.E.L., S.D.C.), Children\u2019s Hospital, Department of Pediatrics, Harvard Medical School (S.E.L., S.D.C.), Department of Pediatrics, Boston Medical Center and Boston University School of Medicine (S.E.L.), and Department of Medicine, Brigham..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas S.","family":"Moodie","sequence":"additional","affiliation":[{"name":"From the Division of Pediatric Cardiology (S.E.L.), University of Rochester Medical Center and Children\u2019s Hospital at Strong and Department of Pediatrics (S.E.L.), University of Rochester School of Medicine and Dentistry, Rochester, NY; Department of Cardiology (S.E.L., S.D.C.), Children\u2019s Hospital, Department of Pediatrics, Harvard Medical School (S.E.L., S.D.C.), Department of Pediatrics, Boston Medical Center and Boston University School of Medicine (S.E.L.), and Department of Medicine, Brigham..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Sopko","sequence":"additional","affiliation":[{"name":"From the Division of Pediatric Cardiology (S.E.L.), University of Rochester Medical Center and Children\u2019s Hospital at Strong and Department of Pediatrics (S.E.L.), University of Rochester School of Medicine and Dentistry, Rochester, NY; Department of Cardiology (S.E.L., S.D.C.), Children\u2019s Hospital, Department of Pediatrics, Harvard Medical School (S.E.L., S.D.C.), Department of Pediatrics, Boston Medical Center and Boston University School of Medicine (S.E.L.), and Department of Medicine, Brigham..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven D.","family":"Colan","sequence":"additional","affiliation":[{"name":"From the Division of Pediatric Cardiology (S.E.L.), University of Rochester Medical Center and Children\u2019s Hospital at Strong and Department of Pediatrics (S.E.L.), University of Rochester School of Medicine and Dentistry, Rochester, NY; Department of Cardiology (S.E.L., S.D.C.), Children\u2019s Hospital, Department of Pediatrics, Harvard Medical School (S.E.L., S.D.C.), Department of Pediatrics, Boston Medical Center and Boston University School of Medicine (S.E.L.), and Department of Medicine, Brigham..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Pediatric Pulmonary and Cardiac Complications of Vertically Transmitted HIV Infection (PC HIV) Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.97.13.1246"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.104.1.e2"},{"key":"e_1_3_2_3_2","unstructured":"Moorthy LN Lipshultz SE. Cardiovascular monitoring of HIV-infected patients. In: Lipshultz SE ed. Cardiology in AIDS. New York NY: Chapman & Hall; 1998:345\u201384."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(96)00230-2"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(86)90771-X"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/46.5.736"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002470050262"},{"key":"e_1_3_2_8_2","first-page":"1103","volume":"6","year":"1993","unstructured":"Mofenson LM, Bethel J, Moye J, et al, for the National Institute of Child Health and Human Development Intravenous Immunoglobulin Clinical Trial Study Group. Effect of intravenous immunoglobulin (IVIG) on CD4+ lymphocyte decline in HIV-infected children in a clinical trial of IVIG infection prophylaxis. J Acquir Immune Defic Syndr. 1993;6:1103\u201313.","journal-title":"J Acquir Immune Defic Syndr"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.105.1.1"},{"key":"e_1_3_2_10_2","first-page":"1","volume":"43","year":"1994","unstructured":"Centers for Disease Control and Prevention. Classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age. MMWR Morb Mortal Wkly Rep. 1994;43:1\u201319.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_3_2_11_2","unstructured":"Langston C Cooper ER Goldfarb J et al for the P2C2 HIV Study Group. HIV-related mortality in infants and children: data from the P2C2 HIV study. Pediatrics. In press."},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.92.8.2220"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.CIR.102.13.1542","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T13:15:56Z","timestamp":1715519756000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.CIR.102.13.1542"}},"subtitle":["The Prospective P\n            <sup>2<\/sup>\n            C\n            <sup>2<\/sup>\n            HIV Multicenter Study"],"short-title":[],"issued":{"date-parts":[[2000,9,26]]},"references-count":12,"journal-issue":{"issue":"13","published-print":{"date-parts":[[2000,9,26]]}},"alternative-id":["10.1161\/01.CIR.102.13.1542"],"URL":"https:\/\/doi.org\/10.1161\/01.cir.102.13.1542","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2000,9,26]]},"assertion":[{"value":"1999-08-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2000-05-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2000-09-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}