title: Noninvasive predictors of mortality for patients with Chagas' heart disease: a multivariate stepwise logistic regression study.
abstract: This prospective investigation was conducted in an attempt to identify noninvasive predictors of mortality for patients with Chagas' heart disease through a multivariate stepwise logistic regression study. Fifty-six patients with a positive complement fixation test for Chagas' disease were followed up at the Cardiomyopathy Clinic of our institution from April 1990 to April 1992. Patient age was 59 +/- 17 years; 28 (50%) were male. Upon admission, 19 patients (33%) were in the New York Heart Association (NYHA) class III and 8 (14%) in the NYHA class IV. Systolic blood pressure was 125 +/- 23 mm Hg, diastolic blood pressure 76 +/- 11 mm Hg and resting heart rate 77 +/- 11 beats/min. Forty patients (71%) were given digitalis and 39 (69%) angiotensin-converting enzyme inhibitors. Plasma Na+ was 140 +/- 4 mEq/l, K+ was 4.34 +/- 0.73 mEq/l and creatinine level 1.34 +/- 0.31 mg/100 ml. Cardiomegaly was observed in the chest X-ray of 41 of 51 (79%) available patients. Atrial fibrillation was observed in the resting ECG of 24 of 54 (44%) available patients, premature ventricular contractions in 23 (41%), right bundle branch block in 26 (46%) and left anterior hemiblock in 26 (46%) patients. Echocardiography revealed a left ventricular ejection fraction of 0.45 +/- 0.16, left ventricular systolic dimension of 51.23 +/- 13.53 mm and left ventricular diastolic dimension of 62.94 +/- 19 mm. Sixteen (28%) patients died during the 2-year study, 11 of them suddenly.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Heart Institute, Santa Casa Hospital, Ribeirão Preto, Brazil.
authors.forename: R B
authors.initials: RB
authors.lastname: Bestetti
authors.forename: C M
authors.initials: CM
authors.lastname: Dalbo
authors.forename: O C
authors.initials: OC
authors.lastname: Freitas
authors.forename: L A
authors.initials: LA
authors.lastname: Teno
authors.forename: O T
authors.initials: OT
authors.lastname: Castilho
authors.forename: J S
authors.initials: JS
authors.lastname: Oliveira
mesh_terms: D000206:Actuarial Analysis; D002598:Chagas Cardiomyopathy / Q000188:drug therapy / Q000401:mortality* / Q000503:physiopathology; D005260:Female; D006439:Hemodynamics; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D013318:Stroke Volume; D016019:Survival Analysis; D017741:Survivors