RESEARCH ARTICLE Ventricular and atrial functions assessed by speckle-tracking echocardiography in patients with human immunodeficiency virus Altug Cincin MD 1 | Beste Ozben MD 1 | Elif Tukenmez Tigen MD 2 | Murat Sunbul MD 1 | Nurten Sayar MD 1 | Emre Gurel MD 1 | Kursat Tigen MD 1 | Volkan Korten MD 2 1 Marmara University School of Medicine Department of Cardiology, Istanbul, Turkey 2 Marmara University School of Medicine Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey Correspondence Beste Ozben, Marmara Universitesi Pendik E gitim ve Aras¸tırma Hastanesi, Fevzi Cakmak Mah. Muhsin Yazicioglu Caddesi No: 10, Kaynarca/Pendik/Istanbul Turkey. Email: besteozben@yahoo.com Abstract Purpose: Antiretroviral therapy (ART) has dramatically changed the clinical manifesta- tion of human immunodeficiency virus (HIV) associated cardiomyopathy from severe left ventricular (LV) systolic dysfunction to a pattern of subclinical cardiac dysfunc- tion. The aim of this study was to evaluate by speckle tracking echocardiography (STE) LV, right ventricular (RV), and biatrial functions in HIV-infected patients under different ART combinations. Methods: We consecutively included 128 HIV-infected patients (mean age 44.2 ± 10.1 years, 110 males) and 100 controls (mean age 42.1 ± 9.4 years, 83 males). Ventricular and atrial functions were assessed by both conventional and STE. Results: Although there was not any significant difference in conventional echocar- diographic variables, HIV-infected patients had significantly lower LV global longitu- dinal strain (GLS), RV GLS, left atrial (LA) reservoir and conduit strain, and right atrial conduit strain. HIV patients receiving integrase strand transfer inhibitors and prote- ase inhibitors (PI) had significantly lower LV GLS and LA conduit strain, while patients receiving non-nucleoside reverse transcriptase inhibitors and PI had significantly lower RV GLS than controls. CD4 count at the time of echocardiography was strongly correlated with LV GLS (r = .619, P < .001) and RV GLS (r = .606, P < .001). Conclusion: Biventricular and atrial functions are subclinically impaired in HIV- infected patients. ART regimen may also affect myocardial functions. KEYWORDS human immunodeficiency virus, speckle tracking echocardiography, strain 1 | INTRODUCTION Deaths related to human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome decline, obviously due to preventive measures and novel therapies. The number of people who have access to combination antiretroviral therapy (ART) con- tinues to rise globally. Yet, the mortality of HIV-infected patients receiving appropriate ART is still higher than that of general population. 1,2 HIV associated cardiomyopathy (HIVAC) is characterized as symptomatic, systolic dysfunction with a dilated left ventricle (LV). Myocarditis from direct HIV toxicity, opportunistic infections, nutri- tional deficiencies, cardiac autoimmunity, chronic inflammation, and ART cardiotoxicity are implicated in causing HIVAC. 3 It is associated Received: 6 May 2020 Revised: 29 July 2020 Accepted: 1 September 2020 DOI: 10.1002/jcu.22921 J Clin Ultrasound. 2020;1–10. wileyonlinelibrary.com/journal/jcu © 2020 Wiley Periodicals LLC 1