Por que os portadores de cardiomiopatia chagásica têm pior evolução que os não-chagásicos?

Abstract

SummaryBackground: Heart failure is a highly prevalent disease, the prognosis of which depends on different predictive factors.

I Diretriz Latino-Americana para o Diagnóstico e Tratamento da Cardiopatia Chagásica

“…That might be due to the following factors: younger patients with less co-morbidities; less severe rejections; low incidence of graft vascular disease; lower prevalence of pulmonary hyper-resistance; and no previous surgery 296 . Reactivation of CD and neoplasms have already been important problems, but that has been overcome with higher experience and with the use of low doses of immunosuppressive drugs or of alternative immunosuppressive regimens 119 .…”

“…Several observational case series have shown a worse outcome for patients with CCC as compared to those with other cardiomyopathies 118,119 . Several pathophysiological factors contribute to that difference, but several studies have reported LV contractility dysfunction as an independent prognostic predictor when assessed via both cardiomegaly on chest XR and LVEF or ventricular diameter 79,85,109,[118][119][120] .…”

“…The combination of ventricular dysfunction with the presence of NSVT on Holter monitoring increases the risk for death during follow-up on average 2.14 times 79,85 . The presence of ventricular arrhythmia in patients with HF increases their chance of SD 79,85,119,120 . Those algorithms can stratify prognosis in a simplified and logical way by using clinical parameters and methods available at most cardiology services in Brazil 79,85 .…”

“…Those algorithms can stratify prognosis in a simplified and logical way by using clinical parameters and methods available at most cardiology services in Brazil 79,85 . In CCC, as in other cardiopathies, other variables, such as FC, RV dysfunction, ventricular diameter, LVEF, VO 2 , duration of exercise, and brain natriuretic peptide (BNP) level, can affect the prognosis 78,86,[119][120][121][122] ( Figure 4). …”

Cardiomiopatia chagásica: prognóstico no perfil clínico-hemodinâmico C

“…In a previous study by our group, we found that chagasic patients have the worst outcomes compared to other etiologies, however, this study included patients with preserved ventricular function and no selection for the clinical-hemodynamic profile 16 . We must also consider that the studies made by Stevenson et al 11 , with evaluation of the clinical profile, were not included patients with Chagas cardiomyopathy.…”