Orlando Simonetti

Equity Interest - Non-publicly traded entity ( e.g., stock, stock option, or other ownership interest)

EXercise MRI evaluation of HIV-PAH Longitudinal Determinants (EXHALTED)

Recent advances in the treatment of patients infected with the human immunodeficiency virus (HIV) have resulted in these patients living longer without overt susceptibility to opportunistic infections. Heart and lung complications are now a leading cause of disability and mortality in the HIV patient. Shortness of breath and exercise limitation (ExLT) are very common in the HIV patient owing to a high prevalence of risk factors such as smoking, lung disease and other poorly understood immune factors unrelated to the burden of the HIV virus. It is very common to miss a serious disorder called pulmonary artery hypertension (PAH) that is 2500 times more common in the HIV patient and often not diagnosed until late in the disease. We have recently provided feasibility data on a unique MRI compatible exercise platform (ExMR) that can provide high-resolution information on right ventricular (RV) function along with assessment of pulmonary artery pressure in response to exercise. In this grant application, we propose a novel use of this technology with a detailed assessment of cardiopulmonary indices to provide information on the prevalence and progression of PAH and progressive impairment in contractile function of the RV that commonly afflicts these patients. We will further analyze inflammatory variables that may predict these changes thus allowing early identification of these patients.