Effect of aerobic fitness on arterial compliance and autonomic modulation in HIV disease.

摘要

Human immunodeficiency virus (HIV) is associated with cardiovascular abnormalities and autonomic dysfunction. Regular physical activity in HIV disease results in an increased aerobic capacity; however the effects of aerobic fitness on vascular and autonomic mechanisms in HIV disease are unknown. We examined differences in arterial compliance, and autonomic modulation in relation to aerobic fitness in HIV positive subjects compared to HIV negative controls.;Subjects were separated into the following groups: (1) unfit HIV negative (HNU, n = 9); (2) fit HIV negative (HNF, n = 11); (3) unfit HIV positive (HPU, n = 15); and (4) fit HIV positive (HPF, n = 13). Thirty-nine males and 9 females completed this study (mean age 40.4 +/- 4.2 yrs). Subjects were matched for age, BMI, and aerobic capacity and were categorized as fit or unfit.;Aerobic fitness was determined using an open-circuit system. Arterial compliance was determined via an applanation tonometer and automated computer program to determine the area under the diastolic curve. Electrocardiographic and blood pressure waveforms were analyzed using power spectral analysis to determine parasympathetic and sympathetic modulations, respectively. Baroreflex sensitivity was obtained using the alpha index. A one way analysis of variance was executed on each dependent variable. A Bonferroni post hoc analysis was conducted on variables which revealed an appropriate F statistic.;Arterial compliance was augmented in HPF vs. HPU [7.4 +/- 1.9 mmHg x sec vs. 4.4 +/- 1.7 mmHg x sec (p = .006)]. Parasympathetic modulation was higher in HPF vs. HPU [2244.5 +/- 2997.6 msec2 vs. 489.1 +/- 552.9 msec2 (p < .05)]. Sympathetic modulation was lower in HPF vs. HNU [4.7 +/- 5.0 mmHg2 vs. 12.9 +/- 9.7 mmHg2 (p < 05)] Baroreflex sensitivity was higher in HPF vs. HPU [17.3 +/- 10.2 msec/mmHg vs. 7.4 +/- 3.8 msec/mmHg, (p = .003)], and HPF vs. HNU 17.3 +/- 10.2 msec/mmHg vs. 6.2 +/- 3.0 msec/mmHg, (p = .004)].;Augmented arterial compliance associated with aerobic fitness portent an improved cardiovascular and autonomic profile for physically active HIV positive individuals. Thus, physical activity may be a cost-effective adjunct therapy to antiretroviral medications and may contribute to our knowledge of pre-clinical manifestations of cardiovascular disease and autonomic dysfunction in HIV disease.