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POTENTIAL ROLE OF TRANSTHORACIC ECHOCARDIOGRAPHY FOR SCREENING LV SYSTOLIC DYSFUNCTION IN PATIENTS WITH A HISTORY OF DENGUE INFECTION. A CROSS-SECTIONAL AND COHORT STUDY AND REVIEW OF THE LITERATURE
Triagem sistólica do VE disfunção em pacientes com história de infecção por dengue.
Corte transversal e estudo de coorte
Revisão da literatura
Cross-sectional and cohort study
Dysfunction in patients with a history of dengue infection
Review of the literature
Author
Affilliation
Universidade Federal do Acre.Centro Multidisciplinário. Cruzeiro do Sul, Acre, Brasil / Department of Cardiology, Copenhagen University Hospital–Herlev and Gentofte, Herlev, Denmark.
Universidade Federal do Acre.Centro Multidisciplinário. Cruzeiro do Sul, Acre, Brasil / Department of Cardiology, Copenhagen University Hospital–Herlev and Gentofte, Herlev, Denmark.
Universidade de São Paulo. Instituto de Ciências Biomédicas. Departamento de Parasitologia. São Paulo, SP, Brasil.
Universidade Federal do Acre.Centro Multidisciplinário. Cruzeiro do Sul, Acre, Brasil / Department of Cardiology, Copenhagen University Hospital–Herlev and Gentofte, Herlev, Denmark.
Universidade Federal do Acre.Centro Multidisciplinário. Cruzeiro do Sul, Acre, Brasil.
Universidade Federal do Acre.Centro Multidisciplinário. Cruzeiro do Sul, Acre, Brasil.
Universidade Federal do Acre.Centro Multidisciplinário. Cruzeiro do Sul, Acre, Brasil.
Universidade Federal do Acre.Centro Multidisciplinário. Cruzeiro do Sul, Acre, Brasil.
National Malaria Reference Laboratory, Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark.
Universidade de São Paulo. Instituto de Ciências Biomédicas. Departamento de Parasitologia. São Paulo, SP, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Imunologia Viral. Rio de Janeiro, RJ, Brasil.
Department of Cardiology, Copenhagen University Hospital–Herlev and Gentofte, Herlev, Denmark / Faculty of Biomedical Sciences, Copenhagen University, Copenhagen, Denmark.
Universidade Federal do Acre. Centro de Ciência Saúde e Esporte. Rio Branco, Acre, Brasil.
Universidade Federal do Acre.Centro Multidisciplinário. Cruzeiro do Sul, Acre, Brasil / Department of Cardiology, Copenhagen University Hospital–Herlev and Gentofte, Herlev, Denmark.
Universidade Federal do Acre.Centro Multidisciplinário. Cruzeiro do Sul, Acre, Brasil / Department of Cardiology, Copenhagen University Hospital–Herlev and Gentofte, Herlev, Denmark.
Universidade de São Paulo. Instituto de Ciências Biomédicas. Departamento de Parasitologia. São Paulo, SP, Brasil.
Universidade Federal do Acre.Centro Multidisciplinário. Cruzeiro do Sul, Acre, Brasil / Department of Cardiology, Copenhagen University Hospital–Herlev and Gentofte, Herlev, Denmark.
Universidade Federal do Acre.Centro Multidisciplinário. Cruzeiro do Sul, Acre, Brasil.
Universidade Federal do Acre.Centro Multidisciplinário. Cruzeiro do Sul, Acre, Brasil.
Universidade Federal do Acre.Centro Multidisciplinário. Cruzeiro do Sul, Acre, Brasil.
Universidade Federal do Acre.Centro Multidisciplinário. Cruzeiro do Sul, Acre, Brasil.
National Malaria Reference Laboratory, Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark.
Universidade de São Paulo. Instituto de Ciências Biomédicas. Departamento de Parasitologia. São Paulo, SP, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Imunologia Viral. Rio de Janeiro, RJ, Brasil.
Department of Cardiology, Copenhagen University Hospital–Herlev and Gentofte, Herlev, Denmark / Faculty of Biomedical Sciences, Copenhagen University, Copenhagen, Denmark.
Universidade Federal do Acre. Centro de Ciência Saúde e Esporte. Rio Branco, Acre, Brasil.
Universidade Federal do Acre.Centro Multidisciplinário. Cruzeiro do Sul, Acre, Brasil / Department of Cardiology, Copenhagen University Hospital–Herlev and Gentofte, Herlev, Denmark.
Abstract
Background
Dengue virus can affect the cardiovascular system and men may be at higher risk of severe
complications than women. We hypothesized that clinical dengue virus (DENV) infection
could induce myocardial alterations of the left ventricle (LV) and that these changes could
be detected by transthoracic echocardiography.
Methodology/Principal findings
We examined individuals from Acre in the Amazon Basin of Brazil in 2020 as part of the
Malaria Heart Study. By questionnaires we collected information on self-reported prior dengue
infection. All individuals underwent transthoracic echocardiography, analysis of left ventricular
ejection fraction (LVEF) and global longitudinal strain (GLS). We included 521
persons (mean age 40±15 years, 39% men, 50% urban areas) of which 253 (49%) had a
history of dengue infection. In multivariable models adjusted for clinical and sociodemographic
data, a history of self-reported dengue was significantly associated with lower LVEF
(β = -2.37, P < 0.01) and lower GLS (β = 1.08, P < 0.01) in men, whereas no significant associations
were found in women (P > 0.05). In line with these findings, men with a history of
dengue had higher rates of LV systolic dysfunction (LVEF < 50% = 20%; GLS < 16% = 17%)
than those without a history of dengue (LVEF < 50% = 7%; GLS < 16% = 8%; P < 0.01 and
0.06, respectively). Conclusions/Significance
The findings of this study suggest that a clinical infection by dengue virus could induce myocardial
alterations, mainly in men and in the LV, which could be detected by conventional
transthoracic echocardiography. Hence, these results highlight a potential role of echocardiography
for screening LV dysfunction in participants with a history of dengue infection. Further
larger studies are warranted to validate the findings of this study.
Keywords in Portuguese
Papel potencial da transtorácica ecocardiografiaTriagem sistólica do VE disfunção em pacientes com história de infecção por dengue.
Corte transversal e estudo de coorte
Revisão da literatura
Keywords
Potential role of transthoracic echocardiographyCross-sectional and cohort study
Dysfunction in patients with a history of dengue infection
Review of the literature
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