Echocardiographic parameters and survival in chagas heart disease with severe systolic dysfunction
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Data
2014
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Resumo
Background: Echocardiography 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.
Objective: To correlate echocardiographic parameters with the endpoint cardiovascular mortality in patients with
ejection fraction < 35%.
Methods: Study 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.
Results: In 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).
Conclusion: The 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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Echocardiography /diagnosis, Chagas disease, Survivorship (public health), Chagas cardiomyopathy
Citação
RASSI, Daniela do Carmo et al. Echocardiographic parameters and survival in chagas heart disease with severe systolic dysfunction. Arquivos Brasileiros de Cardiologia, Rio de Janeiro, v. 102, n. 3, p. 242-252, 2014.