Chagas disease is an endemic disease that in recent decades has ceased to be a rural disease to become mainly an urban disease, becoming a public health problem because it is a life-threatening disease and because 70 million people are at risk of infection. This disease, which has cardiac involvement in its chronic phase, can often be silent and asymptomatic, because of this the establishment of early markers in this type of patients is of great interest. To achieve this goal this study proposes the use of the permutation entropy (PE) which has been shown satisfactory results in the analysis of hearth rhythm and the differentiation between healthy people and people who suffered of congestive heart failure, also known as heart failure. This study analyzes three groups: 83 volunteers (Control), 102 patients with positive serology and no cardiac involvement diagnosed by conventional non-invasive methods (CH1) and 107 patients with positive serology and mild to moderate incipient heart failure (CH2). The used data comes from the 24-hour ECG record, the RR intervals from each of the three groups are shown in 288 frames of 5 minutes. The analysis performed shows significant differences between the three groups, with 90% to 100% specificity and sensitivity, making this study a promising precedent for the development of a low-cost, non-invasive method for detecting possible heart failure in asymptomatic patients.
Chagas disease American trypanosomiasis is caused by a flagellated parasite: trypanosoma cruzi, transmitted by an insect of the genus Triatoma and also by blood transfusions. In Latin America the number of infected people is approximately 6 million, with a population exposed to the risk of infection of 70 million people. It is our interest to develop a low-cost, non-invasive methodology capable of describing cardiac dynamics within 24 hours and thus finding descriptors of dynamics that allow early detection of cardiac abnormality caused by T. cruzi. We analyzed the first and second principal components of the PCA of the 8 HRV indices of the 24-hour RR records in patients with ECG abnormalities (CH2), patients without ECG abnormalities (CH1) who had positive results Serological findings for Chagas disease and healthy (Control) matched for sex and age. We found significant differences (p-value<0.05) between the three groups Control-CH1, Control-CH2 and CH1-CH2 up to 5 continuous hours in dynamics between the, using the HRV heart rate variability indices and the PCA principal component analysis method, and we also found a lower distance from the mean dynamics in the Control group (0.020267), then the CH1 group (0.027922) and finally in group CH2 (0.034812).
Se ha efectuado amplio estudio epídemiolóqico, clínico, electrocardiográfico y profiláctico en relación con la enfermedad de Chagas en los centros poblados más importantes de dos valles del Sur del Perú, demostrándose la presencia de factores epidemiológicos muy favorables para la presencia de esta enfermedad. Casi el 100% de las viviendas tenían T. infesfans y en más del 50% de ellás, estos triatomas estaban infectados por T. cruzi. En el interior de las casas se crían numerosos y variados animales domésticos entre los que predominan cuyes, conejos, gatos y perros, que tienen rol importante como reservorio de T. cruzi. Se ha practicado 320 xenodiagnósticos a igual número de animales de las viviendas de Moquegua, resultando 12 positivos entre 113 perros, 11 positivos en 62 cuyes, 2 positivos entre 68 gatos y 2 positivos en 30 conejos. Los restantes (27 cerdos, 8 caballos, 6 burros y 6 cabras) dieron resultado negativo. Hemos practicado 752 xenodiagnósticos y 553 reacciones de Guerreiro-Machado en un total de 771 personas residentes de esos valles que no fueron previamente seleccionados, lo que permitió el diagnóstico de 105 casos nuevos. Se ha comprobado que la sintomatología y alteraciones electrocardiográficas en estos casos nuevos son muy discretas; es más, esta pobre sintomatología y signos electrocardiográficos fueron, paradógicamente, más frecuentes en los no chagásícos que en los chagásicos. El compromiso cardíaco en los 105 casos referidos no ha sido frecuente ni ha tenido los caracteres de severidad que han sido descritos en otros países de América. Se ha investigado la efectividad del Gamma-B.H.C.-Cereclor contra el T. infestans en los centros poblados del valle de Moquegua, obteniéndose resultados bastante alentadores diez meses después de su aplicación.
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