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AutorSalles, G.
AutorXavier, S.
AutorSouza, A.
AutorHasslocher-Moreno, Alejandro Marcel
AutorCardoso, C.
Data de acesso2019-06-17T12:41:37Z
Data de disponibilização2019-06-17T12:41:37Z
Data do publicação2003
CitaçãoSALLES, G. et al. Prognostic value of QT interval parameters for mortality risk stratification in Chagas disease: result of a long-term follow-up study. Circulation, v. 108, n. 3, p. 305-312, 2003.pt_BR
ISSN0009-7322pt_BR
URIhttps://www.arca.fiocruz.br/handle/icict/33517
Idiomaengpt_BR
EditorAmerican Heart Associationpt_BR
Direito Autoralopen accesspt_BR
TítuloPrognostic value of QT interval parameters for mortality risk stratification in Chagas disease: result of a long-term follow-up studypt_BR
Tipo do documentoArticlept_BR
DOI10.1161/01.CIR.0000079174.13444.9C
Resumo em InglêsBackground: QT interval parameters are potential prognostic markers of arrhythmogenicity risk and cardiovascular mortality and have never been evaluated in Chagas’ disease. Methods and Results: Outpatients (738) in the chronic phase of Chagas’ disease were enrolled in a long-term follow-up study. Maximal heart rate– corrected QT (QTc) and T-wave peak-to-end (TpTe) intervals and QRS, QT, JT, QTapex, and TpTe dispersions and variation coefficients were measured manually and calculated from 12-lead ECGs obtained on admission. Clinical, radiological, and 2-dimensional echocardiographic data were also recorded. Primary end points were all-cause, Chagas’ disease–related, and sudden cardiac mortalities. During a follow-up of 58 39 months, 62 patients died, 54 of Chagas’ disease–related causes and 40 suddenly. Multivariate Cox survival analysis revealed that the QT-interval dispersion (QTd) (hazard ratio, 1.45; 95% confidence interval, 1.29 to 1.63; P0.001, for 10-ms increments) and left ventricular (LV) end-systolic dimension (hazard ratio, 1.36; 95% confidence interval, 1.21 to 1.53; P0.001, for 5-mm increments) were the strongest independent predictors for all end points. The maximum QTc interval (QTcmax) could substitute for QTd with a worse predictive performance. Other predictors were heart rate, presence of pathological Q waves, frequent premature ventricular contractions (PVCs), and isolated left anterior fascicular block (LAFB) on the ECGs. Kaplan-Meier survival curves demonstrated that a QTd 65 ms or a QTcmax 465 ms1/2 discriminated the 2 groups with significantly different prognoses. Conclusions: Electrocardiographic QTd and echocardiographic LV end-systolic dimension were the most important mortality predictors in patients with Chagas’ disease. Heart rate, the presence on ECG of pathological Q waves, frequent PVCs, and isolated LAFB refined the mortality risk stratification.pt_BR
AfiliaçãoFederal University of Rio de Janeiro. Clementino Fraga Filho University Hospital. Department of Internal Medicine. Rio de Janeiro, RJ, Brazil.pt_BR
AfiliaçãoFederal University of Rio de Janeiro. Clementino Fraga Filho University Hospital. Department of Internal Medicine. Rio de Janeiro, RJ, Brazil / Fundação Oswaldo Cruz. Hospital Evandro Chagas. Rio de Janeiro, RJ, Brasil.pt_BR
AfiliaçãoFederal University of Rio de Janeiro. Clementino Fraga Filho University Hospital. Department of Internal Medicine. Rio de Janeiro, RJ, Brazil / Fundação Oswaldo Cruz. Hospital Evandro Chagas. Rio de Janeiro, RJ, Brasil.pt_BR
AfiliaçãoFundação Oswaldo Cruz. Hospital Evandro Chagas. Rio de Janeiro, RJ, Brasil.pt_BR
AfiliaçãoFederal University of Rio de Janeiro. Clementino Fraga Filho University Hospital. Department of Internal Medicine. Rio de Janeiro, RJ, Brazil.pt_BR
Palavras-chave em inglêsCardiomyopathypt_BR
Palavras-chave em inglêsMortalitypt_BR
Palavras-chave em inglêsSudden deathpt_BR
Palavras-chave em inglêsElectrocardiographypt_BR
Palavras-chave em inglêsEchocardiographypt_BR
e-ISSN1524-4539
Data de embargo2020-06-17


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