| Predictors of mortality in patients with Chagas' cardiomyopathy and ventricular tachycardia not treated with implantable cardioverter-defibrillators. | |
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MedLine Citation:
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PMID: 20946310 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: The natural history of the arrhythmogenic form of Chagas' heart disease is not fully understood. METHODS: We assessed the outcome of 56 patients with Chagas' cardiomyopathy ([31 men]; mean age of 55 years; mean left ventricular ejection fraction [LVEF] 42%) presenting with either sustained ventricular tachycardia (VT) or nonsustained VT (NSVT), before therapy with implantable cardioverter-defibrillator was available at our center. RESULTS: Over a mean follow-up of 38 ± 16 months (range, 1-61 months), 16 patients (29%) died, 11 due to sudden cardiac death (SCD), and five from progressive heart failure. Survivors and nonsurvivors had comparable baseline characteristics, except for a lower LVEF (46 ± 7% vs 31 ± 9%, P < 0.001) and a higher New York Heart Association class (P = 0.003) in those who died during follow-up. Receiver-operator characteristic curve analysis showed that an LVEF cutoff value of 38% had the best accuracy for predicting all-cause mortality and an LVEF cutoff value of 40% had the best accuracy for prediction of SCD. Using the multivariate Cox regression analysis, LVEF < 40% was the only predictor of all-cause mortality (hazard ratio [HR] 12.22, 95% confidence interval [CI] 3.46-43.17, P = 0.0001) and SCD (HR 6.58, 95% CI 1.74-24.88, P = 0.005). CONCLUSIONS: Patients with Chagas' cardiomyopathy presenting with either sustained VT or NSVT run a major risk for mortality when had concomitant severe or even moderate LV systolic dysfunction. |
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Authors:
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Alvaro Valentim Lima Sarabanda; José Antônio Marin-Neto |
Publication Detail:
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Type: Journal Article Date: 2010-10-14 |
Journal Detail:
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Title: Pacing and clinical electrophysiology : PACE Volume: 34 ISSN: 1540-8159 ISO Abbreviation: Pacing Clin Electrophysiol Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2011-01-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7803944 Medline TA: Pacing Clin Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 54-62 Citation Subset: IM |
Copyright Information:
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©2010, The Authors. Journal compilation ©2010 Wiley Periodicals, Inc. |
Affiliation:
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Division of Cardiology, Department of Internal Medicine, Medical School of Ribeirão Preto, University of São Paulo, São Paulo, Brazil. saraband@uol.com.br |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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