Holter monitoring in Chagas' heart disease

Grupi, César José; Moffa, Paulo Jorge; Barbosa, Silvio; Sanches, Paulo Cesar R.; Filho, E. G. Barragan; Bellotti, Giovanni; Pileggi, F

doi:10.1590/s1516-31801995000200015

Cited by 11 publications

(9 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…on resting ECG, the VESs are less frequent in patients with chronic Chagas' disease and minimal ECG changes and more frequent and complex when the patient shows characteristic changes, especially when associated with left ventricular dysfunction 33 .…”

Section: Marques Et Al Evaluation Of Asymptomatic Patients With Chronmentioning

confidence: 95%

Avaliação de pacientes assintomáticos com forma crônica da doença de Chagas através da análise do eletrocardiograma dinâmico, ecocardiograma e do peptídeo natriurético tipo B

Marques¹,

Canesin²,

Júnior³

et al. 2006

Arq. Bras. Cardiol.

View full text Add to dashboard Cite

OBJECTIVETo evaluate asymptomatic patients with chronic Chagas' disease to determine prevalence of ventricular arrhythmias, left ventricular dysfunction, and B-type natriuretic peptide (BNP) plasma levels. METHODSOne hundred and six patients from the Chagas' disease outpatient clinic underwent clinical evaluation, electrocardiogram (ECG), cardiothoracic index (CTI), ambulatory electrocardiogram (Holter monitoring), echocardiogram, and BNP measurement and then were distributed into three groups: GI, with normal ECG (n = 50); GIIA, with ECG changes characteristic of Chagas' disease (n = 31); and GIIB, with other ECG changes (n = 25). RESULTSThe most common electrocardiographic changes were the following. GIIA: complete right bundle branch block (35%), left anterior hemiblock (35%), and electrically inactive areas (32%); GIIB: inferolateral repolarization change (28%), and left ventricular overload (24%). Mean CTI index values were similar (p = 0.383). Ventricular arrhythmia prevalence was higher in the GIIA (77%) and GIIB (75%) groups than in the GI group (46%) (p = 0.002). Ventricular dysfunction was more prevalent in the GIIA (52%) and GIIB (32%) groups than in the GI group (14%) (p = 0.001). Systolic dysfunction was more prevalent in the GIIA group (29%) than in the GIIB (20%) and GI groups (2%) (p < 0.001). Diastolic dysfunction was more prevalent in the GIIA (42%) and GIIB (28%) groups than in the GI group (12%) (p = 0.005). Mean B-type natriuretic peptide levels were 30 ± 88 pg/mL in the GI group, 66 ± 194 in the GIIA group and 24 ± 82 for the GIIB group (p = 0.121), respectively. CONCLUSIONArrhythmias and left ventricular dysfunction are more prevalent in asymptomatic patients with chronic Chagas' disease and abnormal ECG than in patients with normal ECG. Plasma BNP levels were similar among the groups. KEY WORDSChagas' disease, ambulatory electrocardiography, Doppler echocardiography, brain natriuretic peptide.

show abstract

Section: Marques Et Al Evaluation Of Asymptomatic Patients With Chronmentioning

confidence: 95%

Avaliação de pacientes assintomáticos com forma crônica da doença de Chagas através da análise do eletrocardiograma dinâmico, ecocardiograma e do peptídeo natriurético tipo B

Marques¹,

Canesin²,

Júnior³

et al. 2006

Arq. Bras. Cardiol.

View full text Add to dashboard Cite

show abstract

“…During this asymptomatic phase, subclinical cardiac involvement can be identified by Holter monitoring and echocardiography. 37,38 Systolic and diastolic left ventricular dysfunction and ventricular arrhythmias have been documented in a high percentage of patients with chronic asymptomatic Chagas disease. 39 Anti-heart antibodies directed against myosin heavy chain, mitochondrial antigens, the β 1 adrenergic receptor, and muscarinic acetylcholine 2 receptors are increased in patients with T cruzi infection who develop myocarditis.…”

Section: Causementioning

confidence: 99%

Myocarditis

2012

View full text Add to dashboard Cite

Myocarditis is an underdiagnosed cause of acute heart failure, sudden death, and chronic dilated cardiomyopathy. In developed countries, viral infections commonly cause myocarditis; however, in the developing world, rheumatic carditis, Trypanosoma cruzi, and bacterial infections such as diphtheria still contribute to the global burden of the disease. The short-term prognosis of acute myocarditis is usually good, but varies widely by cause. Those patients who initially recover might develop recurrent dilated cardiomyopathy and heart failure, sometimes years later. Because myocarditis presents with non-specific symptoms including chest pain, dyspnoea, and palpitations, it often mimics more common disorders such as coronary artery disease. In some patients, cardiac MRI and endomyocardial biopsy can help identify myocarditis, predict risk of cardiovascular events, and guide treatment. Finding effective therapies has been challenging because the pathogenesis of chronic dilated cardiomyopathy after viral myocarditis is complex and determined by host and viral genetics as well as environmental factors. Findings from recent clinical trials suggest that some patients with chronic inflammatory cardiomyopathy have a progressive clinical course despite standard medical care and might improve with a short course of immunosuppression.

show abstract

“…Virtually all types of atrial and ventricular arrhythmias can occur including sinus node dysfunction, intermittent com- plete atrioventricular block, and complex ventricular arrhythmias 52,62 .…”

Section: Ambulatory Electrocardiographic Monitoring -mentioning

confidence: 99%