Clinical Meaning of Ascites in Patients with Endomyocardial Fibrosis

Barretto, Antônio Carlos Pereira; Mady, Charles; Oliveira, Sérgio Almeida de; Arteaga, Edmundo; Bó, Creusa Dal; Ramires, José Antônio Franchini

doi:10.1590/s0066-782x2002000200008

Cited by 19 publications

(12 citation statements)

References 8 publications

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“…Chronic Chagas’ disease was responsible for 8% of deaths (table 1, fig 2). Alcoholic cardiomyopathy, hypertrophic cardiomyopathy and endomyocardial fibrosis are also reported, but their prevalences are low in comparison with other causes of HF 42. Other restrictive and infiltrative cardiomyopathies are even more rarely found in reported series 43.…”

Section: Cardiomyopathiesmentioning

confidence: 95%

“…Tricuspid regurgitation was seen in 58% of these patients and mitral regurgitation in 60%. Analysis of factors influencing the course of endomyocardial fibrosis showed that biventricular involvement (moderate or severe), right ventricular fibrosis, ascites, atrial fibrillation and the presence of tricuspid and mitral regurgitation were associated with greater mortality 42 47. The presence of atrial fibrillation was associated with a greater prevalence of tricuspid regurgitation and fibrosis of the right ventricle.…”

Section: Cardiomyopathiesmentioning

confidence: 99%

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Cardiomyopathy, adult valve disease and heart failure in South America

Bocchi¹,

Guimarães

Tarasoutshi

et al. 2008

Heart

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Continued assessment of temporal trends in mortality and epidemiology of specific cardiovascular diseases in South America is needed to provide a scientific basis for rational allocation of the limited healthcare resources and introduction of strategies to reduce risk and predict the future burden of cardiovascular disease. The epidemiology of cardiomyopathies, adult valve disease and heart failure (HF) in South America is reviewed here. Diseases of the circulatory system are the main cause of death based on data from about 50% of the South American population. Among the cardiovascular causes of death, cerebrovascular disease is predominant followed by ischaemic heart disease, other heart diseases and hypertensive disease. Of note, cerebrovascular disease is the main cause of death in women, and race also influenced cardiovascular mortality rates. HF is the most important cardiovascular reason for admission to hospital due to cardiovascular disease of ischaemic, idiopathic dilated cardiomyopathic, valvular, hypertensive and chagasic aetiologies. Also, mortality due to HF is high, especially owing to Chagas' disease. HF and aetiologies associated with HF are responsible for 6.3% of deaths. Rheumatic fever is the leading cause of valvular heart disease. The findings have important public health implications because the allocation of healthcare resources, and strategies to reduce the risk of HF should also consider controlling Chagas' disease and rheumatic fever in South American countries.

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Section: Cardiomyopathiesmentioning

confidence: 95%

Section: Cardiomyopathiesmentioning

confidence: 99%

Cardiomyopathy, adult valve disease and heart failure in South America

Bocchi¹,

Guimarães

Tarasoutshi

et al. 2008

Heart

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show abstract

“…[113][114][115] Decreased reabsorption of proteins and liver disease with exudative enteropathy may also occur in the most severe cases. 67,[116][117][118][119][120] In addition to nonspecific signs of chronic heart failure, including digital clubbing, growth retardation, testicular atrophy, failure to develop male secondary sexual characteristics, 121,122 and cachexia, more specific features of EMF include hypertrophy of the parotid gland, periorbital edema, and proptosis.…”

Section: Chronic Formmentioning

confidence: 99%

Tropical Endomyocardial Fibrosis

et al. 2016

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Abstract-Tropical endomyocardial fibrosis (EMF) is a neglected disease of poverty that afflicts rural populations in tropical low-income countries, with some certain high-prevalence areas. Tropical EMF is characterized by the deposition of fibrous tissue in the endomyocardium, leading to restrictive physiology. Since the first descriptions in Uganda in 1948, high-frequency areas for EMF have included Africa, Asia, and South America. Although there is no clear consensus on a unified hypothesis, it seems likely that dietary, environmental, and infectious factors may combine in a susceptible individual to give rise to an inflammatory process leading to endomyocardial damage and scar formation. The natural history of EMF includes an active phase with recurrent flare-ups of inflammation evolving to a chronic phase leading to restrictive heart failure. In the chronic phase, biventricular involvement is the most common presentation, followed by isolated right-sided heart disease. Marked ascites out of proportion to peripheral edema usually develops as a typical feature of EMF. EMF carries a very poor prognosis. In addition to medical management of heart failure, early open heart surgery (endocardectomy and valve repair/replacement) appears to improve outcomes to some extent; however, surgery is technically challenging and not available in most endemic areas. Increased awareness among health workers and policy makers is the need of the hour for the unhindered development of efficient preventive and therapeutic strategies.

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“…LV impairment results in pulmonary congestion symptoms, while RV involvement may show characteristics of restrictive cardiomyopathy and also simulate constrictive pericarditis. Failure of one or both atrioventricular valves often occurs 16 .…”

Section: Clinical Aspectsmentioning

confidence: 99%