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2028-12-31
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- INI - Artigos de Periódicos [3645]
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T-WAVE AXIS DEVIATION AS AN INDEPENDENT PREDICTOR OF MORTALITY IN CHRONIC CHAGAS' DISEASE
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Federal University of Rio de Janeiro. Medical Faculty. Clementino Fraga Filho University Hospital. Department of Internal Medicine. Rio de Janeiro, RJ, Brasil.
Federal University of Rio de Janeiro. Medical Faculty. Clementino Fraga Filho University Hospital. Department of Internal Medicine. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Federal University of Rio de Janeiro. Medical Faculty. Clementino Fraga Filho University Hospital. Department of Internal Medicine. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Federal University of Rio de Janeiro. Medical Faculty. Clementino Fraga Filho University Hospital. Department of Internal Medicine. Rio de Janeiro, RJ, Brasil.
Federal University of Rio de Janeiro. Medical Faculty. Clementino Fraga Filho University Hospital. Department of Internal Medicine. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Federal University of Rio de Janeiro. Medical Faculty. Clementino Fraga Filho University Hospital. Department of Internal Medicine. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Federal University of Rio de Janeiro. Medical Faculty. Clementino Fraga Filho University Hospital. Department of Internal Medicine. Rio de Janeiro, RJ, Brasil.
Abstract
The T-wave axis shift has been reported to represent a general marker of ventricular repolarization abnormalities and a potential indicator of increased risk for cardiovascular mortality. We assessed the prognostic importance of the T-wave axis deviation for mortality rate in patients with chronic Chagas’ disease. In a long-term follow-up prospective study, 738 adult outpatients in the chronic phase of Chagas’ disease were enrolled. The frontal plane T-wave axis was estimated from 12-lead electrocardiograms obtained on admission and categorized as normal (15° to 75°), borderline (75° to 105° or 15° to 15°), and abnormal (>105° or < 15°). Clinical and radiologic data, 2-dimensional echocardiographic data, and other electrocardiographic data were also recorded. Primary end points were all-cause, those related to Chagas’ disease, and sudden cardiac deaths. Statistical analyses included Kaplan-Meier estimation of
survival curves and multivariate Cox’s proportional hazards models. During a follow-up of 58 39 months, 62
patients died, 54 from causes related to Chagas’ disease and 40 due to sudden cardiac death. Kaplan-Meier
survival curves showed that the 3 categories of T axis had significantly different prognoses. Multivariate Cox’s survival analysis demonstrated that an abnormal T axis increases the risk of death threefold and sudden death nearly sixfold after adjustment for other covariates, including left ventricular systolic function and other electrocardiographic abnormalities. Borderline T-wave axis also indicated a worse prognosis, particularly in the subgroup of patients with abnormal baseline electrocardiograms. These results indicate that T-wave axis deviation is an easily quantified, strong, and independent mortality risk predictor in patients with chronic Chagas’ disease.
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