Atrial mechanical remodeling and new onset atrial fibrillation in chronic Chagas' heart disease.
Atrial fibrillation (AF) is a common arrhythmia, mechanistically linked to underlying heart disease. AF affects about one fifth of subjects with Chagas' heart disease and is a harbinger of poor prognosis. In a retrospective longitudinal analysis, 50 subjects were investigated in long-term follow-up for the first documented atrial fibrillation (AF) episode. During a follow-up of (mean+/-SD) 84.2+/-39.0 months, nine subjects developed AF (incidence: 3.3+/-1.0%/year). Five subjects had nonfatal embolic stroke and nine died due to cardiac causes. The relative risk of AF for stroke was 3.0 (p=0.22) and for cardiac death was 3.6 (p=0.04). A faster left atrial diameter (LAD) enlargement during follow-up was tracked in subjects with more severe cardiac damage at presentation, and large LAD was detected at both presentation (p=0.02) and end of follow-up (p=0.002) in subjects who experienced AF. Atrial remodeling in chronic Chagas' disease is associated with severity of underlying heart disease at presentation and impacts AF incidence in this population.
Benchimol-Barbosa
Paulo R
PR
Barbosa-Filho
José
J
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000469:parasitology / Q000503:physiopathology*; D016275:Atrial Function / Q000502:physiology*; D014355:Chagas Disease / Q000469:parasitology / Q000503:physiopathology*; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000469:parasitology / Q000503:physiopathology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies