OBJECTIVE: To determine the prevalence and the prognostic value of exercise-induced ventricular arrhythmia (EIVA) in chronic Chagas' heart disease. STUDY DESIGN AND SETTING: An open prospective cohort of 130 clinically stable patients at a University Hospital outpatient unit in Rio de Janeiro, Brazil, was followed up at scheduled clinical visits from 1990 through 2007. The endpoint was total cardiovascular mortality. Survival curves (Kaplan-Meier) and a multivariate Cox proportional hazard model were adjusted to determine the association between EIVA and mortality. RESULTS: The median duration of follow-up was 9.9 years (range, 132 days to 17 years). EIVA prevalence was 43.1% (95% CI: 34.5-51.7). Thirty-three cardiovascular deaths (25.4%) occurred. The hazard ratio of EIVA for cardiovascular death, after adjustment for age, was 1.84 (P = 0.09). An interaction was found between EIVA and cardiomegaly on x-ray. In the group with cardiomegaly, the hazard of dying was four times greater in the presence of EIVA (P for interaction = 0.05). CONCLUSION: In clinically stable chagasic subjects with cardiomegaly, EIVA is a clinically significant marker of total cardiovascular mortality and may be a useful risk stratification tool in this population.
OBJECTIVE: To determine the prevalence and the prognostic value of exercise-induced ventricular arrhythmia (EIVA) in chronic Chagas' heart disease. STUDY DESIGN AND SETTING: An open prospective cohort of 130 clinically stable patients at a University Hospital outpatient unit in Rio de Janeiro, Brazil, was followed up at scheduled clinical visits from 1990 through 2007. The endpoint was total cardiovascular mortality. Survival curves (Kaplan-Meier) and a multivariate Cox proportional hazard model were adjusted to determine the association between EIVA and mortality. RESULTS: The median duration of follow-up was 9.9 years (range, 132 days to 17 years). EIVA prevalence was 43.1% (95% CI: 34.5-51.7). Thirty-three cardiovascular deaths (25.4%) occurred. The hazard ratio of EIVA for cardiovascular death, after adjustment for age, was 1.84 (P = 0.09). An interaction was found between EIVA and cardiomegaly on x-ray. In the group with cardiomegaly, the hazard of dying was four times greater in the presence of EIVA (P for interaction = 0.05). CONCLUSION: In clinically stable chagasic subjects with cardiomegaly, EIVA is a clinically significant marker of total cardiovascular mortality and may be a useful risk stratification tool in this population.
Authors: Leslee J Shaw; Joe X Xie; Lawrence M Phillips; Abhinav Goyal; Harmony R Reynolds; Daniel S Berman; Michael H Picard; Balram Bhargava; Gerard Devlin; Bernard R Chaitman Journal: Heart Asia Date: 2016-06-01
Authors: Sindhu Chadalawada; Anis Rassi; Omar Samara; Anthony Monzon; Deepika Gudapati; Lilian Vargas Barahona; Peter Hyson; Stefan Sillau; Luisa Mestroni; Matthew Taylor; Maria da Consolação Vieira Moreira; Kristen DeSanto; Nelson I Agudelo Higuita; Carlos Franco-Paredes; Andrés F Henao-Martínez Journal: ESC Heart Fail Date: 2021-10-30
Authors: Rudson S Silva; Fernanda S N S Mendes; Jerome L Fleg; Luiz F Rodrigues Junior; Marcelo C Vieira; Isis G G Xavier; Henrique S Costa; Michel S Reis; Flavia Mazzoli-Rocha; Andrea R Costa; Marcelo T Holanda; Henrique H Veloso; Gilberto M Sperandio da Silva; Andréa S Sousa; Roberto M Saraiva; Alejandro Marcel Hasslocher-Moreno; Mauro F F Mediano Journal: Front Med (Lausanne) Date: 2022-09-20