Chagas' Cardiomyopathy Prognosis Assessment through Cardiopulmonary Exercise Testing

Souza, Fernando Cesar de Castro e; Lorenzo, Andrea De; Serra, Salvador Manoel; Colafranceschi, Alexandre Siciliano

doi:10.5935/2359-4802.20150064

Cited by 2 publications

(1 citation statement)

References 21 publications

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“…Oxygen pulse is a CPET variable that can be used as an indirect indicator of LV stroke volume [19], and its association with prognosis in ChC remains uncertain. While Souza et al (2015) found no association between oxygen pulse and death in 2 years [48], Ritt et al (2012) found a correlation between heart failure survival score (a validated prognostic score for HF patients) and oxygen pulse [49]. In our study, this variable presented an inverse association, decreasing the risk of death during the CRP in about 30%.…”

Section: Discussioncontrasting

confidence: 45%

Factors related to the discontinuation and mortality rates of a cardiac rehabilitation programme in patients with Chagas disease: a 6‐year experience in a Brazilian tertiary centre

Vieira

Mendes

Mazzoli‐Rocha

et al. 2021

Tropical Med Int Health

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Objectives To describe the clinical and sociodemographic characteristics of participants as well as discontinuation and mortality rates in a cardiac rehabilitation programme (CRP) tailored to Chagas disease (CD). Methods Participants underwent functional capacity, anthropometry and cardiac function evaluations before beginning a CRP. Univariate and multivariate Cox proportional hazards models were performed to investigate the associations between clinical and sociodemographic characteristics at baseline with discontinuation rates and deaths. Results Forty‐two patients were enrolled in the CRP (61.9% men, mean age of 58.1 ± 11.8 years). During a median follow‐up period of 10.8 months, 74% discontinued and 14% died while enrolled in CRP. 34% of the patients who discontinued CRP died during follow‐up. White race (HR = 0.09; 95% CI 0.01–1.00), right ventricular systolic dysfunction (HR = 10.54; 95% CI 1.24–89.50) and oxygen pulse (HR = 0.69; 95% CI 0.48–0.99) were independently associated with death while enrolled in CRP. Married status (HR = 0.44; 95% CI 0.21–0.95) was independently associated with discontinuation rates from CRP. VO2 peak (HR = 0.85; 95% CI 0.74–0.98) and CRP discontinuation due to CD‐related reasons (HR = 8.33; 95% CI 1.91–36.27) were the variables independently associated with death after discontinuation of CRP. Conclusion In this population, sociodemographic aspects and severity of CD were important determinants of CRP discontinuation and mortality.

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Section: Discussioncontrasting

confidence: 45%

Factors related to the discontinuation and mortality rates of a cardiac rehabilitation programme in patients with Chagas disease: a 6‐year experience in a Brazilian tertiary centre

Vieira

Mendes

Mazzoli‐Rocha

et al. 2021

Tropical Med Int Health

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The association of exercise test variables with long-term mortality in patients with chronic Chagas disease

et al. 2022

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BackgroundThe identification of variables obtained in the exercise test (ET) associated with increased risk of death is clinically relevant and would provide additional information for the management of Chagas disease (CD). The objective of the present study was to evaluate the association of ET variables with mortality in patients with chronic CD.MethodsThis retrospective longitudinal observational study included 232 patients (median age 46.0 years; 50% women) with CD that were followed at the Evandro Chagas National Institute of Infectious Diseases (Rio de Janeiro, Brazil) and performed an ET between 1989 and 2000. The outcome of interest was all-cause mortality.ResultsThere were 103 deaths (44.4%) during a median follow-up of 21.5 years (IQR 25–75% 8.0–27.8), resulting in 24.5 per 1,000 patients/year incidence rate. The ET variables associated with mortality after adjustments for potential confounders were increased maximal (HR 1.02; 95% CI 1.00–1.03 per mmHg) and change (HR 1.03; 95% CI 1.01–1.06 per mmHg) of diastolic blood pressure (DBP) during ET, ventricular tachycardia at rest (HR 3.95; 95% CI 1.14–13.74), during exercise (HR 2.73; 95% CI 1.44–5.20), and recovery (HR 2.60; 95% CI 1.14–5.91), and premature ventricular complexes during recovery (HR 2.06; 1.33–3.21).ConclusionOur findings suggest that ET provides important prognostic value for mortality risk assessment in patients with CD, with hemodynamic (increased DBP during exercise) and electrocardiographic (presence of ventricular arrhythmias) variables independently associated with an increased mortality risk in patients with CD. The identification of individuals at higher mortality risk can facilitate the development of intervention strategies (e.g., close follow-up) that may potentially have an impact on the longevity of patients with CD.

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Chagas' Cardiomyopathy Prognosis Assessment through Cardiopulmonary Exercise Testing

Cited by 2 publications

References 21 publications

Factors related to the discontinuation and mortality rates of a cardiac rehabilitation programme in patients with Chagas disease: a 6‐year experience in a Brazilian tertiary centre

Factors related to the discontinuation and mortality rates of a cardiac rehabilitation programme in patients with Chagas disease: a 6‐year experience in a Brazilian tertiary centre

The association of exercise test variables with long-term mortality in patients with chronic Chagas disease

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