PREDICTIVE FACTORS FOR THE PROGRESSION OF CHRONIC CHAGAS CARDIOMYOPATHY IN PATIENTS WITHOUT LEFT VENTRICULAR DYSFUNCTION
The identification of predictors for the progression of chronic Chagas cardiomyopathy (CCC) is essential to ensure adequate patient management. This study looked into a non-concurrent cohort of 165 CCC patients between 1985 and 2010 for independent predictors for CCC progression. The outcomes were w...
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ftdoajarticles:oai:doaj.org/article:283b79b8cfb74b74a9faadfe23cc8d90 2024-09-09T19:26:30+00:00 PREDICTIVE FACTORS FOR THE PROGRESSION OF CHRONIC CHAGAS CARDIOMYOPATHY IN PATIENTS WITHOUT LEFT VENTRICULAR DYSFUNCTION Silvana de Araújo SILVA Eliane Dias GONTIJO João Carlos Pinto DIAS Camila Gomes de Souza ANDRADE Carlos Faria Santos AMARAL 2015-04-01T00:00:00Z https://doi.org/10.1590/S0036-46652015000200009 https://doaj.org/article/283b79b8cfb74b74a9faadfe23cc8d90 EN eng Universidade de São Paulo (USP) http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652015000200153&lng=en&tlng=en https://doaj.org/toc/1678-9946 1678-9946 doi:10.1590/S0036-46652015000200009 https://doaj.org/article/283b79b8cfb74b74a9faadfe23cc8d90 Revista do Instituto de Medicina Tropical de São Paulo, Vol 57, Iss 2, Pp 153-163 (2015) Chagas cardiomyopathy Clinical progression Prognosis Cohort studies Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2015 ftdoajarticles https://doi.org/10.1590/S0036-46652015000200009 2024-08-05T17:49:30Z The identification of predictors for the progression of chronic Chagas cardiomyopathy (CCC) is essential to ensure adequate patient management. This study looked into a non-concurrent cohort of 165 CCC patients between 1985 and 2010 for independent predictors for CCC progression. The outcomes were worsening of the CCC scores and the onset of left ventricular dysfunction assessed by means of echo-Doppler cardiography. Patients were analyzed for social, demographic, epidemiologic, clinical and workup-related variables. A descriptive analysis was conducted, followed by survival curves based on univariate (Kaplan-Meier and Cox’s univariate model) and multivariate (Cox regression model) analysis. Patients were followed from two to 20 years (mean: 8.2). Their mean age was 44.8 years (20-77). Comparing both iterations of the study, in the second there was a statistically significant increase in the PR interval and in the QRS duration, despite a reduction in heart rates (Wilcoxon < 0.01). The predictors for CCC progression in the final regression model were male gender (HR = 2.81), Holter monitoring showing pauses equal to or greater than two seconds (HR = 3.02) increased cardiothoracic ratio (HR = 7.87) and time of use of digitalis (HR = 1.41). Patients with multiple predictive factors require stricter follow-up and treatment. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Meier ENVELOPE(-45.900,-45.900,-60.633,-60.633) Revista do Instituto de Medicina Tropical de São Paulo 57 2 153 163 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Chagas cardiomyopathy Clinical progression Prognosis Cohort studies Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Chagas cardiomyopathy Clinical progression Prognosis Cohort studies Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Silvana de Araújo SILVA Eliane Dias GONTIJO João Carlos Pinto DIAS Camila Gomes de Souza ANDRADE Carlos Faria Santos AMARAL PREDICTIVE FACTORS FOR THE PROGRESSION OF CHRONIC CHAGAS CARDIOMYOPATHY IN PATIENTS WITHOUT LEFT VENTRICULAR DYSFUNCTION |
topic_facet |
Chagas cardiomyopathy Clinical progression Prognosis Cohort studies Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
The identification of predictors for the progression of chronic Chagas cardiomyopathy (CCC) is essential to ensure adequate patient management. This study looked into a non-concurrent cohort of 165 CCC patients between 1985 and 2010 for independent predictors for CCC progression. The outcomes were worsening of the CCC scores and the onset of left ventricular dysfunction assessed by means of echo-Doppler cardiography. Patients were analyzed for social, demographic, epidemiologic, clinical and workup-related variables. A descriptive analysis was conducted, followed by survival curves based on univariate (Kaplan-Meier and Cox’s univariate model) and multivariate (Cox regression model) analysis. Patients were followed from two to 20 years (mean: 8.2). Their mean age was 44.8 years (20-77). Comparing both iterations of the study, in the second there was a statistically significant increase in the PR interval and in the QRS duration, despite a reduction in heart rates (Wilcoxon < 0.01). The predictors for CCC progression in the final regression model were male gender (HR = 2.81), Holter monitoring showing pauses equal to or greater than two seconds (HR = 3.02) increased cardiothoracic ratio (HR = 7.87) and time of use of digitalis (HR = 1.41). Patients with multiple predictive factors require stricter follow-up and treatment. |
format |
Article in Journal/Newspaper |
author |
Silvana de Araújo SILVA Eliane Dias GONTIJO João Carlos Pinto DIAS Camila Gomes de Souza ANDRADE Carlos Faria Santos AMARAL |
author_facet |
Silvana de Araújo SILVA Eliane Dias GONTIJO João Carlos Pinto DIAS Camila Gomes de Souza ANDRADE Carlos Faria Santos AMARAL |
author_sort |
Silvana de Araújo SILVA |
title |
PREDICTIVE FACTORS FOR THE PROGRESSION OF CHRONIC CHAGAS CARDIOMYOPATHY IN PATIENTS WITHOUT LEFT VENTRICULAR DYSFUNCTION |
title_short |
PREDICTIVE FACTORS FOR THE PROGRESSION OF CHRONIC CHAGAS CARDIOMYOPATHY IN PATIENTS WITHOUT LEFT VENTRICULAR DYSFUNCTION |
title_full |
PREDICTIVE FACTORS FOR THE PROGRESSION OF CHRONIC CHAGAS CARDIOMYOPATHY IN PATIENTS WITHOUT LEFT VENTRICULAR DYSFUNCTION |
title_fullStr |
PREDICTIVE FACTORS FOR THE PROGRESSION OF CHRONIC CHAGAS CARDIOMYOPATHY IN PATIENTS WITHOUT LEFT VENTRICULAR DYSFUNCTION |
title_full_unstemmed |
PREDICTIVE FACTORS FOR THE PROGRESSION OF CHRONIC CHAGAS CARDIOMYOPATHY IN PATIENTS WITHOUT LEFT VENTRICULAR DYSFUNCTION |
title_sort |
predictive factors for the progression of chronic chagas cardiomyopathy in patients without left ventricular dysfunction |
publisher |
Universidade de São Paulo (USP) |
publishDate |
2015 |
url |
https://doi.org/10.1590/S0036-46652015000200009 https://doaj.org/article/283b79b8cfb74b74a9faadfe23cc8d90 |
long_lat |
ENVELOPE(-45.900,-45.900,-60.633,-60.633) |
geographic |
Arctic Meier |
geographic_facet |
Arctic Meier |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista do Instituto de Medicina Tropical de São Paulo, Vol 57, Iss 2, Pp 153-163 (2015) |
op_relation |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652015000200153&lng=en&tlng=en https://doaj.org/toc/1678-9946 1678-9946 doi:10.1590/S0036-46652015000200009 https://doaj.org/article/283b79b8cfb74b74a9faadfe23cc8d90 |
op_doi |
https://doi.org/10.1590/S0036-46652015000200009 |
container_title |
Revista do Instituto de Medicina Tropical de São Paulo |
container_volume |
57 |
container_issue |
2 |
container_start_page |
153 |
op_container_end_page |
163 |
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