Análise temporal da variabilidade da freqüência cardíaca no estado basal em idosos chagásicos na forma indeterminada em área endêmica

Abstract

Resumo Com o objetivo de avaliar a função autonômica cardíaca em pacientes chagásicos residentes em área endêmica, foram avaliados, por meio da análise computadorizada da variabilidade da freqüência cardíaca, 28 pacientes idosos chagásicos na forma indeterminada, 28 pacientes idosos não-chagásicos e 28 adultos jovens. Todos os pacientes chagásicos realizaram eletrocardiograma, radiografia de tórax, estudo radiológico contrastado do esôfago e cólons e ecodopplercardiograma, sendo que os não-chagásicos deixaram de realizar apenas os exames contrastados. Não houve diferença estatisticamente significativa entre os grupos, quanto às dimensões sistólica e diastólica e função sistólica do ventrículo esquerdo. Não houve diferença estatisticamente significante entre os grupos, quanto à duração média do intervalo RR. Quanto à variância, desvio padrão, coeficiente de variação, e ao pNN50, houve diferença estatisticamente significante entre o grupo jovem e os idosos, mas não entre os grupos idosos. Concluímos que, no estado basal, os grupos idosos chagásicos e não-chagásicos não diferiram quanto à modulação autonômica cardíaca no domínio do tempo. Palavras-chaves: Doença de Chagas. Função autonômica cardíaca. Variabilidade da freqüência cardíaca. Análise temporal dos intervalos RR.Abstract With the aim of evaluating the cardiac autonomic function in elderly chagasic patients living in an endemic area, we evaluated, by using computadorized heart rate variability, 28 elderly chagasic with the indeterminate form, 28 elderly non chagasic and 28 young healthy control. In all patients we performed conventional eletrcardiogram, radiological investigation of thorax, and with contrast of esophagus and colons and echodopplercardiogram. Non chagasic patients did not perform only the exams with contrast. The sistolic ventricular funtion was preserved in all subjects. There was no statistically significant difference between the groups with regard to mean duration of RR intervals. Considering the variance, standard deviation, variation coeficient and pNN50 there was statistically significant difference between the young and elderly groups but no difference was found when the analysis was performed in each one separately for these temporal indexes. We conclude that, in basal condition, the groups of elderly chagasic and no chagasic subjects did not differ as much as the cardiac autonomic modulation in time domain.

Effects of Exercise Training on Heart Rate Variability in Chagas Heart Disease

“…HRV is reduced in Chagas patients with and without the cardiac form (including the indeterminate form) 6 , 7 , 9 , 18 , 23 , and the reduction in its indices is correlated with levels of antimuscarinic antibodies 10 , which are increased in infected patients. The levels of these antibodies seem to be associated with clinical markers of autonomic dysfunction 24 , including the reduction of the chronotropic response to stress, suggesting clinical and physiopathological significance in Chagas disease 25 .…”

Study on Chagas disease occurrence in the municipality of Monte Negro, State of Rondônia, Brazilian Amazon

“…In Brazil, this parasitosis has contaminated about 5 million people, while 20 million are at risk of being infected [1][2][3] . Typically, Chagas disease occurs in people who live in rural areas and in poor quality houses where the vector insects can easily lodge and remain out of sight.…”

Aspectos macroscópicos da cardiopatia chagásica crônica no envelhecimento

“…In the few studies investigating the disease in the elderly, most refer to clinical aspects [8][9][10][11][12] . Therefore, based on the increase in aging individuals with Chagas disease and on the fact that there are few pathological studies of Chagas disease in the elderly, the aim of this study was to describe the macroscopic changes of chronic Chagas heart disease in autopsied elderly.…”