{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T08:48:54Z","timestamp":1792658934291,"version":"4.5.0"},"reference-count":37,"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":[[1998,4,7]]},"abstract":"<jats:p>\n            <jats:italic>Background<\/jats:italic>\n            \u2014The frequency of, course of, and factors associated with cardiovascular abnormalities in pediatric HIV are incompletely understood.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods and Results<\/jats:italic>\n            \u2014A baseline echocardiogram (median age, 2.1 years) and 2 years of follow-up every 4 months were obtained as part of a prospective study on 196 vertically HIV-infected children. Age- or body surface area\u2013adjusted\n            <jats:italic>z<\/jats:italic>\n            scores were calculated by use of data from normal control subjects. Although 88% had symptomatic HIV infection, only 2 had CHF at enrollment, with a 2-year cumulative incidence of 4.7% (95% CI, 1.5% to 7.9%). All mean cardiac measurements were abnormal at baseline (decreased left ventricular fractional shortening [LV FS] and contractility and increased heart rate and LV dimension, mass, and wall stresses). Most of the abnormal baseline cardiac measurements correlated with depressed CD4 cell count\n            <jats:italic>z<\/jats:italic>\n            scores and the presence of HIV encephalopathy. Heart rate and LV mass showed significantly progressive abnormalities, whereas FS and contractility tended to decline. No association was seen between longitudinal changes in FS and CD4 cell count\n            <jats:italic>z<\/jats:italic>\n            score. Children who developed encephalopathy during follow-up had depressed initial FS, and FS continued to decline during follow-up.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            \u2014Subclinical cardiac abnormalities in HIV-infected children are common, persistent, and often progressive. Dilated cardiomyopathy (depressed contractility and dilatation) and inappropriate LV hypertrophy (elevated LV mass in the setting of decreased height and weight) were noted. Depressed LV function correlated with immune dysfunction at baseline but not longitudinally, suggesting that the CD4 cell count may not be a useful surrogate marker of HIV-associated LV dysfunction. However, the development of encephalopathy may signal a decline in FS.\n          <\/jats:p>","DOI":"10.1161\/01.cir.97.13.1246","type":"journal-article","created":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T00:41:02Z","timestamp":1339461662000},"page":"1246-1256","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":128,"title":["Left Ventricular Structure and Function in Children Infected With Human Immunodeficiency Virus"],"prefix":"10.1161","volume":"97","author":[{"given":"Steven E.","family":"Lipshultz","sequence":"first","affiliation":[{"name":"From the Department of Cardiology (S.E.L., S.D.C.) and Division of Infectious Diseases (K.M.), Children\u2019s Hospital, and Department of Pediatrics, Harvard Medical School (S.E.L., S.D.C., K.M.); Department of Pediatrics, Boston City Hospital and Boston University School of Medicine, Boston, Mass (S.E.L.); Departments of Biostatistics and Epidemiology (K.A.E., M.D.S.) and Pediatrics, Division of Pediatric Cardiology (D.S.M.), Cleveland Clinic Foundation, Cleveland, Ohio; Department of Medicine, Brigham..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirk A.","family":"Easley","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (S.E.L., S.D.C.) and Division of Infectious Diseases (K.M.), Children\u2019s Hospital, and Department of Pediatrics, Harvard Medical School (S.E.L., S.D.C., K.M.); Department of Pediatrics, Boston City Hospital and Boston University School of Medicine, Boston, Mass (S.E.L.); Departments of Biostatistics and Epidemiology (K.A.E., M.D.S.) and Pediatrics, Division of Pediatric Cardiology (D.S.M.), Cleveland Clinic Foundation, Cleveland, Ohio; Department of Medicine, Brigham..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. John","family":"Orav","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (S.E.L., S.D.C.) and Division of Infectious Diseases (K.M.), Children\u2019s Hospital, and Department of Pediatrics, Harvard Medical School (S.E.L., S.D.C., K.M.); Department of Pediatrics, Boston City Hospital and Boston University School of Medicine, Boston, Mass (S.E.L.); Departments of Biostatistics and Epidemiology (K.A.E., M.D.S.) and Pediatrics, Division of Pediatric Cardiology (D.S.M.), Cleveland Clinic Foundation, Cleveland, Ohio; Department of Medicine, Brigham..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Kaplan","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (S.E.L., S.D.C.) and Division of Infectious Diseases (K.M.), Children\u2019s Hospital, and Department of Pediatrics, Harvard Medical School (S.E.L., S.D.C., K.M.); Department of Pediatrics, Boston City Hospital and Boston University School of Medicine, Boston, Mass (S.E.L.); Departments of Biostatistics and Epidemiology (K.A.E., M.D.S.) and Pediatrics, Division of Pediatric Cardiology (D.S.M.), Cleveland Clinic Foundation, Cleveland, Ohio; Department of Medicine, Brigham..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J.","family":"Starc","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (S.E.L., S.D.C.) and Division of Infectious Diseases (K.M.), Children\u2019s Hospital, and Department of Pediatrics, Harvard Medical School (S.E.L., S.D.C., K.M.); Department of Pediatrics, Boston City Hospital and Boston University School of Medicine, Boston, Mass (S.E.L.); Departments of Biostatistics and Epidemiology (K.A.E., M.D.S.) and Pediatrics, Division of Pediatric Cardiology (D.S.M.), Cleveland Clinic Foundation, Cleveland, Ohio; Department of Medicine, Brigham..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Timothy","family":"Bricker","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (S.E.L., S.D.C.) and Division of Infectious Diseases (K.M.), Children\u2019s Hospital, and Department of Pediatrics, Harvard Medical School (S.E.L., S.D.C., K.M.); Department of Pediatrics, Boston City Hospital and Boston University School of Medicine, Boston, Mass (S.E.L.); Departments of Biostatistics and Epidemiology (K.A.E., M.D.S.) and Pediatrics, Division of Pediatric Cardiology (D.S.M.), Cleveland Clinic Foundation, Cleveland, Ohio; Department of Medicine, Brigham..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wyman W.","family":"Lai","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (S.E.L., S.D.C.) and Division of Infectious Diseases (K.M.), Children\u2019s Hospital, and Department of Pediatrics, Harvard Medical School (S.E.L., S.D.C., K.M.); Department of Pediatrics, Boston City Hospital and Boston University School of Medicine, Boston, Mass (S.E.L.); Departments of Biostatistics and Epidemiology (K.A.E., M.D.S.) and Pediatrics, Division of Pediatric Cardiology (D.S.M.), Cleveland Clinic Foundation, Cleveland, Ohio; Department of Medicine, Brigham..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas S.","family":"Moodie","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (S.E.L., S.D.C.) and Division of Infectious Diseases (K.M.), Children\u2019s Hospital, and Department of Pediatrics, Harvard Medical School (S.E.L., S.D.C., K.M.); Department of Pediatrics, Boston City Hospital and Boston University School of Medicine, Boston, Mass (S.E.L.); Departments of Biostatistics and Epidemiology (K.A.E., M.D.S.) and Pediatrics, Division of Pediatric Cardiology (D.S.M.), Cleveland Clinic Foundation, Cleveland, Ohio; Department of Medicine, Brigham..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"McIntosh","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (S.E.L., S.D.C.) and Division of Infectious Diseases (K.M.), Children\u2019s Hospital, and Department of Pediatrics, Harvard Medical School (S.E.L., S.D.C., K.M.); Department of Pediatrics, Boston City Hospital and Boston University School of Medicine, Boston, Mass (S.E.L.); Departments of Biostatistics and Epidemiology (K.A.E., M.D.S.) and Pediatrics, Division of Pediatric Cardiology (D.S.M.), Cleveland Clinic Foundation, Cleveland, Ohio; Department of Medicine, Brigham..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark D.","family":"Schluchter","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (S.E.L., S.D.C.) and Division of Infectious Diseases (K.M.), Children\u2019s Hospital, and Department of Pediatrics, Harvard Medical School (S.E.L., S.D.C., K.M.); Department of Pediatrics, Boston City Hospital and Boston University School of Medicine, Boston, Mass (S.E.L.); Departments of Biostatistics and Epidemiology (K.A.E., M.D.S.) and Pediatrics, Division of Pediatric Cardiology (D.S.M.), Cleveland Clinic Foundation, Cleveland, Ohio; Department of Medicine, Brigham..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven D.","family":"Colan","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (S.E.L., S.D.C.) and Division of Infectious Diseases (K.M.), Children\u2019s Hospital, and Department of Pediatrics, Harvard Medical School (S.E.L., S.D.C., K.M.); Department of Pediatrics, Boston City Hospital and Boston University School of Medicine, Boston, Mass (S.E.L.); Departments of Biostatistics and Epidemiology (K.A.E., M.D.S.) and Pediatrics, Division of Pediatric Cardiology (D.S.M.), Cleveland Clinic Foundation, Cleveland, Ohio; Department of Medicine, Brigham..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(89)90014-3"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199210293271802"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(92)91592-V"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1993.03500220055026"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-199304000-00010"},{"key":"e_1_3_2_6_2","first-page":"174","volume":"5","year":"1994","unstructured":"Grenier MA, Karr SS, Rakusan TA, Martin GR. Cardiac disease in children with HIV: relationship of cardiac disease to HIV symptomatology. Pediatr AIDS HIV Infect. 1994;5:174\u2013179.","journal-title":"Pediatr AIDS HIV Infect"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)90987-3"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.92.8.2220"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-199502000-00008"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-199502000-00011"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(95)70275-X"},{"key":"e_1_3_2_12_2","unstructured":"Lindegren ML Caldwell B Oxtoby M. Paediatric HIV infection in the U S A. In: Mok JYQ Newell M-L eds. HIV Infection in Children: A Guide to Practical Management. New York NY: Cambridge University Press; 1995:21\u201351."},{"key":"e_1_3_2_13_2","unstructured":"Lipshultz SE Bancroft EA Boller A-M. Cardiovascular manifestations of HIV infection in children. In: Bricker JT Garson A Jr Fisher DJ Neish SR eds. The Science and Practice of Pediatric Cardiology. 2nd ed. Baltimore Md: Williams & Wilkins; 1997."},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/66.3.660"},{"key":"e_1_3_2_15_2","unstructured":"Kearney DL for the P2C2 HIV Study Group. Postmortem cardiomegaly correlates with premortem measurements of left ventricular size in malnourished HIV-infected children. Third Conference on Retroviruses and Opportunistic Infections. Washington DC January 28\u2013February 1 1996 (session 67). Abstract 431."},{"key":"e_1_3_2_16_2","unstructured":"Lipshultz SE for the P2C2 HIV Study Group. Cardiac dysfunction predicts mortality in HIV-infected children: The prospective NHLBI P2C2 Study. Third Conference on Retroviruses and Opportunistic Infections. Washington DC January 28\u2013February 1 1996 (session 65). Abstract 415."},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(95)70397-7"},{"key":"e_1_3_2_18_2","unstructured":"Lipshultz SE Easley K Kaplan S Bricker JT Starc T Lai W Moodie D Colan SD for the P2C2 Study Group. The relation between progressive immune dysfunction and ventricular dysfunction: the prospective NHLBI P2C2 study. 2nd International Conference on Retroviruses. Proceedings Washington DC January 29\u2013February 2 1995;90. Abstract 193."},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(96)00230-2"},{"key":"e_1_3_2_20_2","first-page":"225","volume":"36","year":"1987","unstructured":"Centers for Disease Control and Prevention. Classification system for human immunodeficiency virus (HIV) infection in children under 13 years of age. 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CD4 and CD8 lymphocytes in diagnosis and disease progression of pediatric HIV infection. Pediatr AIDS HIV Infect. 1996;7:20\u201330.","journal-title":"Pediatr AIDS HIV Infect"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.97.5.710"},{"key":"e_1_3_2_34_2","unstructured":"Scientific Advisory Committee on Surrogate Markers of HIV. Consensus statement. J Acquir Immun Defic Syndr Hum Retrovirol. 1995;10(suppl 2):S114\u2013S116."},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-118-9-199305010-00003"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)90006-X"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-199502000-00008"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.CIR.97.13.1246","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T16:34:44Z","timestamp":1715531684000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.CIR.97.13.1246"}},"subtitle":["The Prospective P\n            <sup>2<\/sup>\n            C\n            <sup>2<\/sup>\n            HIV Multicenter Study"],"short-title":[],"issued":{"date-parts":[[1998,4,7]]},"references-count":37,"journal-issue":{"issue":"13","published-print":{"date-parts":[[1998,4,7]]}},"alternative-id":["10.1161\/01.CIR.97.13.1246"],"URL":"https:\/\/doi.org\/10.1161\/01.cir.97.13.1246","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[1998,4,7]]},"assertion":[{"value":"1997-04-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1997-12-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"1998-04-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}