Mechanisms of Diastolic Dysfunction Among Persons With HIV Compared With Non-HIV Control Subjects

HIV positive subjects Inclusion Criteria: * age ≥40 and ≤75 years * documented HIV infection * participant report that combination antiretroviral therapy (cART) (any regimen) has been taken stably without \> 4 week interruption for at least 180 days prior to study entry (report of switching regimens in that time frame is permissible) Exclusion Criteria: * CD4 \< 100 cell/mm3 * current active AIDS-defining illness * current active or recent (not fully resolved within 30 days prior to study entry) systemic bacterial, fungal, parasitic, or viral infections (except HIV, HBV, human papillomavirus \[HPV\], or HCV) * current active cancer * clinical ASCVD, as defined by 2013 ACC/AHA guidelines (including previous diagnosis of AMI, ACS, stable or unstable angina, coronary or other arterial revascularization, stroke, TIA, PAD), by subject report * clinical diagnosis of HFpEF or HFrEF, by subject report * diagnosed DM on antihyperglycemic medication * current, active use of immune suppressant medication including oral or intravenous corticosteroid or injectable biologic (oral ASA or NSAID use permitted) * eGFR \<45 ml/min/1.73 m2 calculated by CDK-EPI * standard contraindications to MRI procedure based on MGH MRI Patient Procedure Screening Form - including history of severe allergy to gadolinium * use of lipid lowering agents including statin drugs, fibrates, ezetimibe, red yeast rice, niacin or omega-3 fatty acids (\>3 grams/day in standalone formulations) in the 90 days prior to study entry * use of ACE inhibitor, ARB, or aldosterone receptor blocker in the 90 days prior to study entry * pregnancy or breastfeeding (female subjects of reproductive potential) * other medical, psychiatric, or psychological condition that, in the opinion of the study investigator, would interfere with completion of study procedures HIV negative subjects: Inclusion Criteria: • age ≥40 and ≤75 years Exclusion Criteria: * HIV infection * current active or recent (not fully resolved within 30 days prior to study entry) systemic bacterial, fungal, parasitic, or viral infections (except HIV, HBV, human papillomavirus \[HPV\], or HCV) * current active cancer * clinical ASCVD, as defined by 2013 ACC/AHA guidelines (including previous diagnosis of AMI, ACS, stable or unstable angina, coronary or other arterial revascularization, stroke, TIA, PAD), by subject report * clinical diagnosis of HFpEF or HFrEF, by subject report * diagnosed DM on antihyperglycemic medication * current, active use of immune suppressant medication including oral or intravenous corticosteroid or injectable biologic (oral ASA or NSAID use permitted) * eGFR \<45 ml/min/1.73 m2 calculated by CDK-EPI * standard contraindications to MRI procedure based on MGH MRI Patient Procedure Screening Form - including history of severe allergy to gadolinium * use of lipid lowering agents including statin drugs, fibrates, ezetimibe, red yeast rice, niacin or omega-3 fatty acids (\>3 grams/day in standalone formulations) in the 90 days prior to study entry * use of ACE inhibitor, ARB, or aldosterone receptor blocker in the 90 days prior to study entry * pregnancy or breastfeeding (female subjects of reproductive potential) * other medical, psychiatric, or psychological condition that, in the opinion of the study investigator, would interfere with completion of study procedures