Heart failure is one of the most important causes of morbidity and mortality in the United States. Both HIV and cocaine abuse can cause left ventricular (LV) dysfunction (systolic, diastolic or both), possibly resulting from separate mechanisms. These etiologies have not been thoroughly investigated. The pathological processes preceding the development of global LV dysfunction are commonly regional in nature. While HAART improves survival in patients with HIV, their impact on LV dysfunction still is not fully understood. The proposed study will enroll 800 black men and women, aged 25-45 years, who have no evidence of hypertension or coronary artery disease or symptoms believed to be due to cardiovascular disease: 200 will be HIV (+) and cocaine (+); 200 HIV (+) and cocaine (-); 200 HIV (-) and cocaine (+); and 200 HIV (-) and cocaine (-). Interviews, echocardiographic examinations, lipid profiles, serum cytokines and other blood tests will be performed at baseline. The study subjects will be re-examined 2 years later and followed up at least 2 years.
The specific aims of the study are: 1) to estimate the prevalence and incidence of regional and global LV dysfunction 2) to investigate the factors associated with the development of regional and global LV dysfunction 3) to investigate the impact of HAART on the development of regional and global LV dysfunction 4) to investigate the individual and joint effects of HIV infection, cocaine use risk behaviors, and other factors, including cigarette smoking, alcohol use, lipid profile, and C-reactive protein and cytokines on the development of regional and global LV dysfunction in black men and women. This study has the potential to provide critical information about the impact of HIV, cocaine abuse and HAART on the development of LV dysfunction.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA015020-03
Application #
6793208
Study Section
Special Emphasis Panel (ZRG1-AARR-1 (06))
Program Officer
Khalsa, Jagjitsingh H
Project Start
2002-08-01
Project End
2007-06-30
Budget Start
2004-07-01
Budget End
2005-06-30
Support Year
3
Fiscal Year
2004
Total Cost
$615,593
Indirect Cost
Name
Johns Hopkins University
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21218
Lai, Shenghan; Heaphy, Christopher M; Rizzo, Anthony J et al. (2018) Cocaine use may induce telomere shortening in individuals with HIV infection. Prog Neuropsychopharmacol Biol Psychiatry 84:11-17
Lai, Shenghan; Gerstenblith, Gary; Moore, Richard D et al. (2017) Cocaine use may modify HIV/ART-associated myocardial steatosis and hepatic steatosis. Drug Alcohol Depend 177:84-92
Sandfort, Veit; Bluemke, David A; Vargas, Jose et al. (2017) Coronary Plaque Progression and Regression in Asymptomatic African American Chronic Cocaine Users With Obstructive Coronary Stenoses: A Preliminary Study. J Addict Med 11:126-137
Lai, Hong; Moore, Richard; Celentano, David D et al. (2016) HIV Infection Itself May Not Be Associated With Subclinical Coronary Artery Disease Among African Americans Without Cardiovascular Symptoms. J Am Heart Assoc 5:e002529
Lai, Hong; Stitzer, Maxine; Treisman, Glenn et al. (2015) Cocaine Abstinence and Reduced Use Associated With Lowered Marker of Endothelial Dysfunction in African Americans: A Preliminary Study. J Addict Med 9:331-9
Lai, Shenghan; Gerstenblith, Gary; Li, Ji et al. (2015) Chronic cocaine use and its association with myocardial steatosis evaluated by 1H magnetic resonance spectroscopy in African Americans. J Addict Med 9:31-9
Liu, Chia-Ying; Bluemke, David A; Gerstenblith, Gary et al. (2014) Reference values of myocardial structure, function, and tissue composition by cardiac magnetic resonance in healthy African-Americans at 3T and their relations to serologic and cardiovascular risk factors. Am J Cardiol 114:789-795
Liu, Chia-Ying; Bluemke, David A; Gerstenblith, Gary et al. (2014) Myocardial steatosis and its association with obesity and regional ventricular dysfunction: evaluated by magnetic resonance tagging and 1H spectroscopy in healthy African Americans. Int J Cardiol 172:381-387
Lai, Shenghan; Fishman, Elliot K; Gerstenblith, Gary et al. (2013) Vitamin D deficiency is associated with coronary artery calcification in cardiovascularly asymptomatic African Americans with HIV infection. Vasc Health Risk Manag 9:493-500
Lai, Hong; Fishman, Elliot K; Gerstenblith, Gary et al. (2013) Vitamin D deficiency is associated with development of subclinical coronary artery disease in HIV-infected African American cocaine users with low Framingham-defined cardiovascular risk. Vasc Health Risk Manag 9:729-37

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