Mittal CM; Wig N;
Mishra S; Deepak KK
Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar,
New Delhi 110029, India.
BACKGROUND: Heart rate variability
(HRV) is a marker of cardiac autonomic tone. Depressed HRV has been reported in
patients with AIDS. We conducted this study to find out if HRV is depressed in
human immunodeficiency virus (HIV)-positive individuals without AIDS. METHODS:
We studied prospectively HRV by spectral analysis of short-term
electrocardiography (ECG) monitoring in 21 HIV-positives (33+/-11 years) and in
18 healthy volunteers (31+/-9 years). None of the HIV-positives had any
clinical evidence of autonomic or cardiac dysfunction. Echocardiography was
also performed in HIV-seropositives to rule out left
ventricular (LV) systolic dysfunction. All these individuals did not have any
evidence of AIDS. RESULTS: Mean CD4+ lymphocyte count was 426+/-166/mm(3). The ejection fraction (EF%)
of HIV patients was 62.4+/-6.4. The total power of HRV was reduced
significantly in HIV-positive individuals (p<0.00001). All the components of
HRV were reduced. CONCLUSIONS: HRV is reduced in HIV-seropositive individuals
in early stages of infection as well without any clinical evidence of autonomic
dysfunction. This may serve as an early marker of future global sympatho-vagal imbalance.