Clinical and therapeutics aspects of heart failure due to Chagas disease
Document title: Clinical and therapeutics aspects of heart failure due to Chagas disease
Journal: Arquivos brasileiros de cardiologia
Database: PERIÓDICA
System number: 000288993
ISSN: 0066-782X
Authors: 1
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Institutions: 1Universidade Federal da Bahia, Salvador, Bahia. Brasil
Year:
Season: Abr
Volumen: 86
Number: 4
Pages: 297-302
Country: Brasil
Language: Portugués, inglés
Document type: Artículo
Approach: Analítico
English abstract OBJECTIVE: Describe the clinical and therapeutic characteristics of patients with heart failure (HF) secondary to chronic chagasic cardiomyopathy and evaluate if these characteristics are different from those found in other etiologies. METHODS: A prospective analysis of the patients treated between August 2003 and June 2004 at a HF referral outpatient clinic was conducted. RESULTS: Three hundred and fifty six patients diagnosed with HF were included in the study. Chagasic cardiomyopathy was the most common etiology (48% of the cases). Other etiologies included hypertensive cardiomyopathy in 19% of the patients, idiopathic dilated in 11% and ischemic in 9%. Patients with HF secondary to chagasic cardiomyopathy were more frequently from non-white ethnic groups (88 vs. 75%; p = 0.002), had a family history of Chagas disease (57 vs. 21%; p = 0.001), had the disease for a longer length of time (71 vs. 56 months; p = 0.034), had lower levels of education (4.4 ± 4.1 vs. 5.7 ± 4.2 years of study; p = 0.004), had a lower heart rate (69 ± 12 vs. 73 ± 13; p = 0.03) and a lower systolic blood pressure (121 ± 25 vs. 129 ± 28 mmHg; p = 0.006). There was also a higher incidence of the use of amiodarone (22 vs. 13%; p = 0.036) and artificial pacemakers (15 vs. 1%; p = 0.001). There was a lower usage of beta-blockers (39 vs. 59%; p = 0.001). CONCLUSION: In this sample of HF outpatients, in a state with a high prevalence of Chagas disease, chagasic cardiomyopathy was the most common etiology and they presented some unique clinical and therapeutic characteristics in comparison to other heart failure patients
Portuguese abstract OBJETIVO: Descrever as características clínicas e terapêuticas de pacientes com insuficiência cardíaca (IC) secundária a miocardiopatia chagásica crônica, bem como avaliar se estas são diferentes nas demais etiologias. MÉTODOS: Foram analisados prospectivamente pacientes atendidos no período de agosto de 2003 a junho de 2004, em um ambulatório de referência para IC. RESULTADOS: Foram incluídos 356 pacientes com o diagnóstico de IC. Miocardiopatia chagásica foi a etiologia mais freqüente, (48% dos casos). Outras etiologias foram miocardiopatia hipertensiva em 19%, dilatada idiopática em 11%, e isquêmica em 9%. Pacientes com IC secundária a miocardiopatia chagásica tinham com maior freqüência etnia não-branca (88 x 75%; p = 0,002), história familiar de doença de Chagas (57 x 21%; p = 0,001), maior tempo de doença (71 x 56 meses; p = 0,034), menor escolaridade (4,4 ± 4,1 x 5,7 ± 4,2 anos de estudo; p = 0,004), menor freqüência cardíaca (69 ± 12 x 73 ± 13; p = 0,03) e pressão arterial sistólica (121 ± 25 x 129 ± 28 mmHg; p = 0,006). Utilizavam com maior freqüência amiodarona (22 x 13%; p = 0,036) marcapassos artificiais (15 x 1%; p = 0,001) e com menor freqüência drogas betabloqueadoras (39 x 59%; p = 0,001). CONCLUSÃO: Nessa amostra de pacientes ambulatoriais com IC, em um estado com alta prevalência de doença de Chagas, miocardiopatia chagásica foi a etiologia mais freqüente, apresentando algumas características clínicas e terapêuticas diferentes dos demais pacientes
Disciplines: Medicina
Keyword: Microbiología,
Sistema cardiovascular,
Terapéutica y rehabilitación,
Miocardiopatía,
Enfermedad de Chagas,
Insuficiencia cardiaca,
Epidemiología,
Características clínicas
Keyword: Medicine,
Cardiovascular system,
Microbiology,
Therapeutics and rehabilitation,
Cardiomyopathies,
Chagas disease,
Heart failure,
Epidemiology,
Clinical characteristics
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