Background: Numerous reports suggest an increased rate of ischemic heart disease (IHD) among human immunodeficiency virus (HIV) infected patients. Several data showed that endothelial dysfunction is a major mechanism in the development of coronary atherosclerosis in non-HIV infected patients. Some regulators of coronary blood flow, as potassium channels (i.e. KATP and Kv) and eNOS have been showed as involved in IHD susceptibility.
Aim: In HIV patients on HAART and an apparently low risk for cardiovascular events we aim to assess coronary anatomy, coronary plaque morphology and microvascular integrity correlating it with the presence of some genetic variants encoding for coronary ion channels.
Methods: We will enrol 100 HIV-infected patients on HAART with Framingham risk score 50% stenosis (expected almost 30 subjects) will undergo coronary angiography, virtual histology-intravascular ultrasound (VH-IVUS) and Doppler-flow wire in order to identified plaque components as dense calcium, necrotic core, fibro-fatty tissue, or fibrous tissue, with the cross-sectional area and percentage of total plaque area reported for each component. Moreover, microvascular function will be assessed by measuring coronary flow velocity reserve (CFR) evaluating both endothelium-dependent and non-endothelium-dependent microvascular function. Patients from group A and B will undergo genetic analysis for polymorphisms of genes encoding for coronary ion channels (i.e. KATP and Kv) and eNOS by PCR.
Expected results: Using multiparametric approach, we expected to observe different pathophysiological mechanisms for HIV-related IHD with a peculiar genetic susceptibility.
