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Reduced Cardiac Selenium Content in the Acquired Immunodeficiency Syndrome

Division of Gastroenterology, New York Medical College, Valhalla, New York

Paul P. Antonecchia, B.S.

Division of Gastroenterology, New York Medical College, Valhalla, New York

Fred Smith, M.D.

Department of Pathology, New York Medical College, Valhalla, New York

Lisa Weiss, BSN

Division of Gastroenterology, New York Medical College, Valhalla, New York

Marianna Davidian, M.D.

Department of Pathology, New York Medical College, Valhalla, New York

Dave Rubin, M.D.

Division of Cardiology, the Department of Medicine, New York Medical College, Valhalla, New York

William S. Rosenthal, M.D.

Division of Gastroenterology, New York Medical College, Valhalla, New York

Selenium deficiency has been implicated in the pathogenesis of a dilated congestive cardiomyopathy in areas of China (Keshan disease) and in several patients on long-term total parenteral nutrition. Recently a clinically and pathologically similar cardiomyopathy has been described in AIDS. Since blood selenium levels are low in AIDS, we assayed cardiac selenium status by a spectrofluorometric method in eight AIDS patients at autopsy compared to nine age-matched, non-AIDS autopsy controls with histologically normal hearts. We found (mean ± SD) a cardiac selenium level of 0.327 ± 0.082 µg/g dry weight in AIDS vs 0.534 ± 0.184 µg/g dry weight in controls ( p<0.01; Student's t test). There were no significant differences between the groups for heart weight, serum CPK, or other laboratory parameters. No specific chest x-ray or electrocardiographic abnormalities were present. Histologically, all AIDS hearts were abnormal; mostly with mild degrees of muscle hypertrophy or fibrosis. Foci of myocytolysis and myocyte necrosis and fibrous replacement of myocytes and monocytic infiltration were present in two AIDS cases.

We conclude that heart tissue in AIDS demonstrates a significant selenium deficit. These data provide a potential link between selenium deficiency and cardiomyopathy in AIDS. (Journal of Parenteral and Enteral Nutrition 13:644-647,1989)

Journal of Parenteral and Enteral Nutrition, Vol. 13, No. 6, 644-647 (1989)
DOI: 10.1177/0148607189013006644


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