Cardiomiopatia chagásica: prognóstico no perfil clínico-hemodinâmico C

Cardoso, Juliano; Novaes, Milena; Ochiai, Marcelo Eidi; Kelly, Regis B.; Morgado, Paulo; Munhoz, Robinson Tadeu; Brancalhão, Euler; Lima, Marcelo; Barretto, Antônio Carlos Pereira

doi:10.1590/s0066-782x2010005000112

Cited by 13 publications

(7 citation statements)

References 12 publications

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“…9 In our study, the average age of chagasic patients was not significantly lower than that of non-chagasic patients. Some studies have shown an average age that is even lower in the chagasic group as a result of the pathogen- esis of the disease, such as the study by Cardoso et al, 10 which found an average age of 53 years.…”

Section: Discussionmentioning

confidence: 97%

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Decompensated chagasic heart failure versus non-chagasic heart failure at a tertiary care hospital: Clinical characteristics and outcomes

Santos

Rocha

Oliveira

et al. 2017

Rev. Assoc. Med. Bras.

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Section: Discussionmentioning

confidence: 97%

“…Cardoso et al 10 conducted a cohort study that assessed patients with clinical hemodynamic profile C, according to the classification given by Stevenson. Systolic blood pressure (SBP) was compared in chagasic and non-chagasic patients, resulting in 89.3±17.1 mmHg versus 98.8±21.7 mmHg (p=0.03).…”

Section: Discussionmentioning

confidence: 99%

Decompensated chagasic heart failure versus non-chagasic heart failure at a tertiary care hospital: Clinical characteristics and outcomes

Santos

Rocha

Oliveira

et al. 2017

Rev. Assoc. Med. Bras.

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“…However, CHD has a specific autonomic imbalance, a different pattern of myocardial fibrosis associated with an inflammatory milieu generated by parasite and host defenses, an increased risk of complex arrhythmias and a known worse prognosis than cardiomyopathies from other etiologies [42, 43]. …”

Section: Discussionmentioning

confidence: 99%

Effect of physical exercise training in patients with Chagas heart disease: study protocol for a randomized controlled trial (PEACH study)

Mendes

Sousa

Souza

et al. 2016

Trials

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Background: The effects of exercise training on Chagas heart disease are still unclear. This study aimed to evaluate the effect of exercise training over functional capacity, cardiac function, quality of life, and biomarkers in Chagas heart disease. Methods: The PEACH study is a superiority randomized clinical trial which will include subjects who meet the following criteria: Chagas heart disease with a left ventricular ejection fraction below 45 % with or without heart failure symptoms; clinical stability in the last 3 months; adherence to clinical treatment; and age above 18 years. The exclusion criteria are: pregnancy; neuromuscular limitations; smoking; evidence of non-chagasic heart disease; systemic conditions that limit exercise practice or cardiopulmonary exercise test; unavailability to attend the center three times a week during the intervention period; and practitioners of regular exercise. The intervention group will perform an exercise training intervention three times per week during 6 months and will be compared to the control group without exercise. Both groups will undergo the same monthly pharmaceutical and nutritional counseling as well as standard medical treatment according to the Brazilian consensus on Chagas disease. The primary outcome is functional capacity based on peak exercise oxygen consumption during cardiopulmonary exercise testing. Secondary outcomes are: cardiac function; body composition; muscle respiratory strength; microvascular reactivity; cardiac rhythm abnormalities; autonomic function; biochemical; oxidative stress and inflammatory biomarkers; and quality of life. Subjects will be evaluated at baseline, and at 3 and 6 months after randomization. Thirty patients will be randomly assigned into exercise or control groups at a ratio of 1:1.

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“…Patients who are typically hospitalized in our medical facility are those with severe advanced heart failure in a decompensation period that does not respond to initial therapy; frequently, these patients present with low cardiac output (10). In our service, dobutamine is preferred over milrinone.…”

Section: And Methodsmentioning

confidence: 99%

Short-Term Add-On Therapy With Angiotensin Receptor Blocker for End-Stage Inotrope-Dependent Heart Failure Patients: B-Type Natriuretic Peptide Reduction in a Randomized Clinical Trial

Ochiai

Brancalhao

Puig

et al. 2012

Journal of Cardiac Failure

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OBJECTIVE:We aimed to evaluate angiotensin receptor blocker add-on therapy in patients with low cardiac output during decompensated heart failure. METHODS: We selected patients with decompensated heart failure, low cardiac output, dobutamine dependence, and an ejection fraction ,0.45 who were receiving an angiotensin-converting enzyme inhibitor. The patients were randomized to losartan or placebo and underwent invasive hemodynamic and B-type natriuretic peptide measurements at baseline and on the seventh day after intervention. ClinicalTrials.gov: NCT01857999. RESULTS: We studied 10 patients in the losartan group and 11 patients in the placebo group. The patient characteristics were as follows: age 52.7 years, ejection fraction 21.3%, dobutamine infusion 8.5 mcg/kg.min, indexed systemic vascular resistance 1918.0 dynes.sec/cm 5 .m 2 , cardiac index 2.8 L/min.m 2 , and B-type natriuretic peptide 1,403 pg/mL. After 7 days of intervention, there was a 37.4% reduction in the B-type natriuretic peptide levels in the losartan group compared with an 11.9% increase in the placebo group (mean difference, -49.1%; 95% confidence interval: -88.1 to -9.8%, p = 0.018). No significant difference was observed in the hemodynamic measurements. CONCLUSION: Short-term add-on therapy with losartan reduced B-type natriuretic peptide levels in patients hospitalized for decompensated severe heart failure and low cardiac output with inotrope dependence.

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Cardiomiopatia chagásica: prognóstico no perfil clínico-hemodinâmico C

Cited by 13 publications

References 12 publications

Decompensated chagasic heart failure versus non-chagasic heart failure at a tertiary care hospital: Clinical characteristics and outcomes

Decompensated chagasic heart failure versus non-chagasic heart failure at a tertiary care hospital: Clinical characteristics and outcomes

Effect of physical exercise training in patients with Chagas heart disease: study protocol for a randomized controlled trial (PEACH study)

Short-Term Add-On Therapy With Angiotensin Receptor Blocker for End-Stage Inotrope-Dependent Heart Failure Patients: B-Type Natriuretic Peptide Reduction in a Randomized Clinical Trial

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