Background and Objectives: Subclinical myocardial deformation and ventricular repolarization abnormalities may occur in people with HIV (PWH) despite preserved left ventricular ejection fraction (LVEF). We evaluated left ventricular global longitudinal strain (LV GLS) and Tpeak-to-end (Tp-e)-based repolarization indices in PWH and examined their within-person relationship. Materials and Methods: This prospective comparative cross-sectional study included 25 PWH and 47 HIV-negative reference participants consecutively recruited from outpatient clinics. All participants were in sinus rhythm and had LVEF ≥50%. Conventional and speckle-tracking echocardiography and 12-lead electrocardiography were performed. Multivariable linear regression assessed associations of HIV status with LV GLS, Tp-e interval, and Tp-e/QTc ratio after adjustment for age, sex, current smoking, and hyperlipidemia. Within-PWH associations were assessed using Spearman correlation with multiplicity adjustment. Results: PWH had less negative LV GLS than reference participants (−17.1% vs. −19.0%; p < 0.001), longer Tp-e intervals (74 vs. 72 ms; p = 0.001), and higher Tp-e/QTc ratios (0.185 vs. 0.173; p < 0.001). HIV status remained associated with LV GLS (B = 2.472 percentage points, 95% CI 1.672–3.272), Tp-e (B = 4.347 ms, 95% CI 2.286–6.408), and Tp-e/QTc (B = 0.013, 95% CI 0.009–0.017; all p < 0.001). Within PWH, LV GLS was not significantly correlated with Tp-e or Tp-e/QTc. Conclusions: PWH with preserved LVEF showed less negative LV GLS and less favorable Tp-e-based repolarization indices than HIV-negative reference participants. These cross-sectional findings do not establish causal, prognostic, or screening implications, and the non-significant within-PWH correlations do not exclude potentially relevant associations. Larger longitudinal studies are warranted.

Background/Objectives: Multiple sclerosis (MS) has been associated with subclinical cardiovascular involvement, including impaired myocardial deformation and increased arterial stiffness. However, the local elastic properties of the ascending aorta and their relationship with subclinical left ventricular (LV) longitudinal dysfunction remain insufficiently characterized in MS. Methods: In this prospective cross-sectional study, 67 adults with MS and 67 age-matched controls without cardiovascular disease underwent standardized transthoracic echocardiography. Aortic strain, distensibility and stiffness index (β) were derived from M-mode ascending aortic diameters and simultaneous brachial blood pressure, and LV global longitudinal strain (GLS) was measured by two-dimensional speckle-tracking echocardiography. Multivariable linear regression was utilized to assess associations. Results: LV ejection fraction was similar between groups, while LV GLS was less negative in MS (−17.49 ± 1.81% vs. −19.85 ± 1.80%, p < 0.001). Patients with MS had lower aortic strain (7.54 ± 3.66% vs. 12.91 ± 3.84%) and distensibility (3.81 [2.23–6.06] vs. 5.95 [4.90–9.26] × 10⁻³ mmHg⁻¹) and a higher stiffness index (4.77 [3.10–7.10] vs. 3.44 [2.31–4.05]) (all p < 0.001). After adjustment for age, sex, and body mass index, MS remained independently associated with aortic strain, distensibility, and stiffness index. Within the MS group, aortic strain was independently associated with LV GLS after adjustment for age, sex, body mass index, Expanded Disability Status Scale score and LDL cholesterol (B = −0.276, standardized β = −0.558, p < 0.001). LV GLS was independently associated with log-transformed distensibility (B = −1.021, p = 0.011) and stiffness index (B = 1.095, p = 0.014). Conclusions: Patients with MS show concurrent, inter-related impairment of local ascending aortic elasticity and LV longitudinal deformation despite preserved ejection fraction. Further studies are needed to establish the temporal sequence and prognostic relevance of these findings.