Echocardiographic Parameters and Survival in Chagas Heart Disease with
Severe Systolic Dysfunction |
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Authors: | Daniela do Carmo Rassi Marcelo Luiz Campos Vieira Ana Lúcia Martins Arruda Viviane Tiemi Hotta Rogério Gomes Furtado Danilo Teixeira Rassi Salvador Rassi |
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Institution: | 1. Faculdade de Medicina e Hospital das Clínicas da Universidade Federal de Goiás (UFG), Goiânia, GO - Brazil ;2. Instituto do Coração da Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, SP - Brazil ;3. Instituto de Radiologia da Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, SP - Brazil |
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Abstract: | BackgroundEchocardiography provides important information on the cardiac evaluation of
patients with heart failure. The identification of echocardiographic parameters in
severe Chagas heart disease would help implement treatment and assess prognosis.
ObjectiveTo correlate echocardiographic parameters with the endpoint cardiovascular
mortality in patients with ejection fraction < 35%. MethodsStudy with retrospective analysis of pre-specified echocardiographic parameters
prospectively collected from 60 patients included in the Multicenter Randomized
Trial of Cell Therapy in Patients with Heart Diseases (Estudo Multicêntrico
Randomizado de Terapia Celular em Cardiopatias) - Chagas heart disease arm. The
following parameters were collected: left ventricular systolic and diastolic
diameters and volumes; ejection fraction; left atrial diameter; left atrial
volume; indexed left atrial volume; systolic pulmonary artery pressure; integral
of the aortic flow velocity; myocardial performance index; rate of increase of
left ventricular pressure; isovolumic relaxation time; E, A, Em, Am and Sm wave
velocities; E wave deceleration time; E/A and E/Em ratios; and mitral
regurgitation. ResultsIn the mean 24.18-month follow-up, 27 patients died. The mean ejection fraction
was 26.6 ± 5.34%. In the multivariate analysis, the parameters ejection fraction
(HR = 1.114; p = 0.3704), indexed left atrial volume (HR = 1.033; p < 0.0001)
and E/Em ratio (HR = 0.95; p = 0.1261) were excluded. The indexed left atrial
volume was an independent predictor in relation to the endpoint, and values >
70.71 mL/m2 were associated with a significant increase in mortality
(log rank p < 0.0001). ConclusionThe indexed left atrial volume was the only independent predictor of mortality in
this population of Chagasic patients with severe systolic dysfunction. |
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Keywords: | Echocardiography / diagnosis Survivorship (Public Health) Chagas Cardiomyopathy Chagas Disease |
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