Cardiac resynchronization therapy in patients with chronic Chagas
cardiomyopathy: long-term follow up |
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Authors: | Edgard Ferreira de Araújo Eduardo Gregório Chamlian Alexey Pomares Peroni Wilson Lopes Pereira Sylvio Matheus de Aquino Gandra Luiz Antonio Rivetti |
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Institution: | 1. Cardiologic Unit of Salinas, Salinas, MG, Brazil. ;2. Faculty of Medical Sciences of Santa Casa de São Paulo (FCMSCSP), São Paulo, SP, Brazil. |
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Abstract: | IntroductionChagas disease is a major cause of cardiomyopathy and sudden death in our country.
It has a high mortality when their patients develop New York Heart Association
(NYHA) class IV.ObjectiveThe objective of this study is to analyze the clinical outcome of patients with
Chagas'' cardiomyopathy with congestive heart failure with optimized
pharmacological therapy, undergoing cardiac resynchronization therapy.MethodsBetween January 2004 and February 2009, 72 patients with Chagas'' cardiomyopathy in
NYHA class III and IV underwent cardiac resynchronization therapy and were
monitored to assess their clinical evolution. We used the t test or the Wilcoxon
test to compare the same variable in two different times. A P
value < 0.05 was established as statistically significant.ResultsThe average clinical follow-up was 46.6 months (range 4-79 months). At the end of
the evaluation, 87.4% of patients were in NYHA class I or II
(P<0.001). There was response to therapy in 65.3% of patients
(P<0.001), with an overall mortality of 34.7%.ConclusionIn patients with chronic Chagas cardiomyopathy undergoing cardiac
resynchronization therapy, we found the following statistically significant
changes: improvement in NYHA class and increase of left ventricle ejection
fraction, a decrease of the systolic final diameter and systolic final left
ventricle volume and improvement of patient survival. |
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Keywords: | Chagas disease Chagas cardiomyopathy Myocarditis Cardiomyopathy dilated Death sudden cardiac |
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