[Predictors of heart failure in chronic chagasic cardiomyopathy with asymptomatic left ventricular dysfunction].
OBJECTIVE
The development of asymptomatic left ventricular dysfunction signifies a worsening of chronic chagasic cardiomyopathy. Our objective was to identify factors that predict the development of heart failure and all-cause mortality.


METHODS
The study included 95 patients with an echocardiographic diagnosis of asymptomatic left ventricular dysfunction. The patients' clinical, electrocardiographic and echocardiographic characteristics were recorded. Factors associated with the development of heart failure were evaluated by Cox regression modeling. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. Receiver operating characteristic (ROC) curves were used to evaluate the sensitivity and specificity of continuous variables identified as significant in the regression analysis.


RESULTS
Patients (mean age, 55 [11] years) were followed up for a median of 63 months (interquartile range, 32-110 months). Univariate analysis showed that there were significant differences in mild and severe systolic dysfunction, age on admission, and E-point-to-septal separation, while the only significant predictors of heart failure found on Cox regression analysis were severe systolic dysfunction (HR=3.53; 95% CI, 1.21-10.30; P=.021) and E-point-to-septal separation (HR=1.12; 95% CI, 1.02-1.23; P=.014). The mortality rate was 3% (3/95) in patients who continued to have asymptomatic left ventricular dysfunction and 37% (10/27) in those who developed heart failure.


CONCLUSIONS
The E-point-to-septal separation and the presence of severe systolic dysfunction can serve as predictors of heart failure in patients with chronic chagasic cardiomyopathy and asymptomatic left ventricular dysfunction.
Petti
Marcos A
MA
Servicio de Cardiología, Sección Enfermedad de Chagas e Insuficiencia Cardíaca, Hospital Eva Perón, San Martín, Buenos Aires, Argentina. mapetti@intraed.net
Viotti
Rodolfo
R
Armenti
Alejandro
A
Bertocchi
Graciela
G
Lococo
Bruno
B
Alvarez
María G
MG
Vigliano
Carlos
C
D002598:Chagas Cardiomyopathy / Q000150:complications*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018487:Ventricular Dysfunction, Left / Q000150:complications*