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Predictors of mortality in patients with Chagas' cardiomyopathy and ventricular tachycardia not treated with implantable cardioverter-defibrillators.
MedLine Citation:
PMID:  20946310     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
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.
Authors:
Alvaro Valentim Lima Sarabanda; José Antônio Marin-Neto
Publication Detail:
Type:  Journal Article     Date:  2010-10-14
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  34     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  54-62     Citation Subset:  IM    
Copyright Information:
©2010, The Authors. Journal compilation ©2010 Wiley Periodicals, Inc.
Affiliation:
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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