Please use this identifier to cite or link to this item:
https://www.arca.fiocruz.br/handle/icict/70075
Type
ArticleCopyright
Open access
Collections
- INI - Artigos de Periódicos [3646]
Metadata
Show full item record
PREDICTORS OF INCIDENT HEART FAILURE IN PATIENTS WITH CHRONIC CHAGAS DISEASE CARDIOMYOPATHY
Author
Cunha, Danton Machado da
Mediano, Mauro Felippe Felix
Rimolo, Lorena dos Santos Marreto
Costa, Andrea Rodrigues da
Diogo, Danilo Bento
Sangenis, Luiz Henrique Conde
Veloso, Henrique Horta
Holanda, Marcelo Teixeira de
Hasslocher-Moreno, Alejandro Marcel
Cunha, Ademir Batista da
Saraiva, Roberto Magalhães
Mediano, Mauro Felippe Felix
Rimolo, Lorena dos Santos Marreto
Costa, Andrea Rodrigues da
Diogo, Danilo Bento
Sangenis, Luiz Henrique Conde
Veloso, Henrique Horta
Holanda, Marcelo Teixeira de
Hasslocher-Moreno, Alejandro Marcel
Cunha, Ademir Batista da
Saraiva, Roberto Magalhães
Affilliation
Fluminense Federal University. Antonio Pedro University Hospital. Niterói, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Clinical Research Laboratory in Chagas Disease. Rio de Janeiro, RJ, Brazil.
Fluminense Federal University. Antonio Pedro University Hospital. Niterói, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Clinical Research Laboratory in Chagas Disease. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Clinical Research Laboratory in Chagas Disease. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Clinical Research Laboratory in Chagas Disease. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Clinical Research Laboratory in Chagas Disease. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Clinical Research Laboratory in Chagas Disease. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Clinical Research Laboratory in Chagas Disease. Rio de Janeiro, RJ, Brazil.
Fluminense Federal University. Antonio Pedro University Hospital. Niterói, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Clinical Research Laboratory in Chagas Disease. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Clinical Research Laboratory in Chagas Disease. Rio de Janeiro, RJ, Brazil.
Fluminense Federal University. Antonio Pedro University Hospital. Niterói, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Clinical Research Laboratory in Chagas Disease. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Clinical Research Laboratory in Chagas Disease. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Clinical Research Laboratory in Chagas Disease. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Clinical Research Laboratory in Chagas Disease. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Clinical Research Laboratory in Chagas Disease. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Clinical Research Laboratory in Chagas Disease. Rio de Janeiro, RJ, Brazil.
Fluminense Federal University. Antonio Pedro University Hospital. Niterói, RJ, Brazil.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Clinical Research Laboratory in Chagas Disease. Rio de Janeiro, RJ, Brazil.
Abstract
Purpose: Patients with chronic Chagas cardiomyopathy (CCC) have a high mortality due to heart failure (HF). The aim of this study was to investigate clinical and echocardiographic predictors of incident HF in patients with CCC. Methods: Single-center retrospective longitudinal observational study which included 176 adult patients (59.1% women; 53.9 ± 10 years old; mean left ventricular [LV] ejection fraction 62% ± 10%) at an early stage of CCC (electrocardiogram and/or wall motion changes but no HF). The primary outcome was incident HF. The association between studied parameters with incident HF was performed by competing-risk survival regression models using the Fine and Gray method. Results: After a mean follow-up of 8.8 ± 3.6 years, 42 patients progressed to HF (27.04 cases/1000 patient-years). A
model 0 adjusted for clinical and 2D-Doppler echocardiographic parameters and for all-cause mortality revealed diabetes mellitus (HR 4.91, 95% CI 1.67–14.4, p = 0.004), LV ejection fraction (HR 0.96, 95% CI 0.93–0.99, p = 0.022), and E’ velocity (HR 0.79, 95% CI 0.67–0.95, p = 0.01) as independently associated with incident HF. The addition of strain-derived parameters to model 0 revealed that LV global circumferential strain (HR 0.83, 95% CI 0.78–0.89, p < 0.001) and left atrial booster contraction strain (HR 1.14, 95% CI 1.02–1.28, p = 0.022) were associated with incident HF. Conclusion: While most clinical parameters were not associated with incident HF in patients with CCC, echocardiographic parameters, including LV systolic and diastolic function and strain-derived parameters, were associated with incident HF in patients with CCC. This knowledge can be very useful for planning the care and follow-up of these patients.
Share