BACKGROUND: Chagas cardiomyopathy and ischemic heart disease (IHD) are frequent causes of chronic systolic heart failure (CHF) in areas where the former is endemic. Nonetheless, a specific comparison of outcome and role of etiology of CHF failure has not been performed in patients with both conditions. METHODS: Two-hundred twenty two patients with Chagas cardiomyopathy and 79 with IHD with CHF were included in the study. A Cox proportional hazards model was used to establish independent predictors of mortality for the studied population. Survival analysis was performed with the Kaplan-Meir product limit method. RESULTS: In the multivariable model, Beta-Blocker therapy [(hazard ratio (HR)=0.36; 95% confidence interval (CI) 0.24 to 0.52; p<0.005)], Chagas etiology of CHF (HR=3.6; 95% CI 2.0 to 6.5; p<0.005), serum sodium levels (HR=0.95; 95% CI 0.91 to 0.98; p<0.005), digoxin use (HR=2.1; 95% CI 1.19 to 3.80, p=0.01), and spironolactone use (HR=1.7; 95% CI 1.10 to 2.80; p=0.02) were determined independent predictors of all-cause mortality for this cohort. Probability of survival at 12, 24, 36, 48, and 60 months was 92%, 92%, 88%, 81%, and 78%, respectively, in IHD patients, and 79%, 61%, 49%, 41%, and 35%, respectively, in Chagas cardiomyopathy patients (p<0.005). CONCLUSION: Outcome in patients with chronic systolic heart failure secondary to Chagas cardiomyopathy is poorer than that seen in those with IHD.
BACKGROUND:Chagas cardiomyopathy and ischemic heart disease (IHD) are frequent causes of chronic systolic heart failure (CHF) in areas where the former is endemic. Nonetheless, a specific comparison of outcome and role of etiology of CHF failure has not been performed in patients with both conditions. METHODS: Two-hundred twenty two patients with Chagas cardiomyopathy and 79 with IHD with CHF were included in the study. A Cox proportional hazards model was used to establish independent predictors of mortality for the studied population. Survival analysis was performed with the Kaplan-Meir product limit method. RESULTS: In the multivariable model, Beta-Blocker therapy [(hazard ratio (HR)=0.36; 95% confidence interval (CI) 0.24 to 0.52; p<0.005)], Chagas etiology of CHF (HR=3.6; 95% CI 2.0 to 6.5; p<0.005), serum sodium levels (HR=0.95; 95% CI 0.91 to 0.98; p<0.005), digoxin use (HR=2.1; 95% CI 1.19 to 3.80, p=0.01), and spironolactone use (HR=1.7; 95% CI 1.10 to 2.80; p=0.02) were determined independent predictors of all-cause mortality for this cohort. Probability of survival at 12, 24, 36, 48, and 60 months was 92%, 92%, 88%, 81%, and 78%, respectively, in IHD patients, and 79%, 61%, 49%, 41%, and 35%, respectively, in Chagas cardiomyopathypatients (p<0.005). CONCLUSION: Outcome in patients with chronic systolic heart failure secondary to Chagas cardiomyopathy is poorer than that seen in those with IHD.
Authors: Marcelo Arruda Nakazone; Maurício Nassau Machado; Ana Paula Otaviano; Ana Maria Silveira Rodrigues; Augusto Cardinalli-Neto; Reinaldo Bulgarelli Bestetti Journal: Cardiol Res Pract Date: 2020-07-06 Impact factor: 1.866
Authors: Alfredo Molina-Berríos; Carolina Campos-Estrada; Michel Lapier; Juan Duaso; Ulrike Kemmerling; Norbel Galanti; Jorge Ferreira; Antonio Morello; Rodrigo López-Muñoz; Juan Diego Maya Journal: Parasitol Res Date: 2013-05-17 Impact factor: 2.289
Authors: Jacqueline E Sherbuk; Emi E Okamoto; Morgan A Marks; Enzo Fortuny; Eva H Clark; Gerson Galdos-Cardenas; Angel Vasquez-Villar; Antonio B Fernandez; Thomas C Crawford; Rose Q Do; Jorge Luis Flores-Franco; Rony Colanzi; Robert H Gilman; Caryn Bern Journal: Glob Heart Date: 2015-09
Authors: Guilherme Wesley Peixoto da Fonseca; Tania Garfias Macedo; Nicole Ebner; Marcelo Rodrigues Dos Santos; Francis Ribeiro de Souza; Charles Mady; Liliam Takayama; Rosa Maria Rodrigues Pereira; Wolfram Doehner; Stefan D Anker; Carlos Eduardo Negrão; Maria Janieire de Nazaré Nunes Alves; Stephan von Haehling Journal: ESC Heart Fail Date: 2020-08-28