The clinical significance of determining arterial stiffness in patients infected with the human immunodeficiency virus

Introduction. Arterial wall stiffness is an indicator that depends not only on age and blood pressure, but also on the activity of the inflammatory process, the rigidity of the muscular layer of arterioles, the presence of heart and kidney failure, type II diabetes mellitus, as well as genetic predisposition. The aim of the study was to evaluate arterial stiffness by the traditional method of oscillometric registration of pulse wave velocities in the aorta, brachial artery and their augmentation indices, to determine the clinical and prognostic significance of its increase in patients infected with the human immunodeficiency virus. Materials and methods. In order to determine the relationship of arterial stiffness indices with clinical, laboratory and instrumental data in patients infected with the human immunodeficiency virus (HIV), 240 patients were examined. After examination using noninvasive arteriographic oscillometry by the Tensiomed Arteriograph 24 medical device, the patients were divided into two groups, depending on the presence and absence of signs of brachial artery stiffness. Increased arterial stiffness was determined when the pulse wave velocity on the brachial artery increased by more than 10 m/s and the brachial artery augmentation index increased by more than 10%. Rigidity was assessed by the indicator of total peripheral vascular resistance. Results. HIV-infected patients in 12.7% of cases have signs of increased arterial stiffness. Increased arterial stiffness was more common in smoking patients and less common in alcohol drinkers. Left atrial dilation and signs of pulmonary heart failure were more often detected in the group with increased arterial stiffness. The chances of an increase in the volume of the left atrium against the background of increased arterial stiffness increase 2.7 times. In patients with increased arterial stiffness, a lower serum iron content, increased activity of matrix metalloproteinase1, as well as an increase in the rate of erythrocyte sedimentation were noted. Conclusion. In patients with HIV infection, it is advisable to assess the stiffness of the arterial wall using an oscillometric method in order to predict the development of left atrial dilation.