title: Morbidity and prognostic factors in chronic chagasic cardiopathy.
abstract: Chagas disease is a pleomorphic clinical entity that has several unique features. The aim of this study is to summarise some of the recent contributions from our research group to knowledge of the morbidity and prognostic factors in Chagas heart disease. A retrospective study suggested that ischaemic stroke associated with left ventricular (LV) apical thrombi is the first clinical manifestation of Chagas disease observed in a large proportion of patients. LV function and left atrial volume (LAV) are independent risk factors for ischaemic cerebrovascular events during follow-up of Chagas heart disease patients. Pulmonary congestion in Chagas-related dilated cardiomyopathy is common but usually mild. Although early right ventricular (RV) involvement has been described, we have shown by Doppler echocardiography that RV dysfunction is evident almost exclusively when it is associated with left ventricle dilatation and functional impairment. In addition, RV dysfunction is a powerful predictor of survival in patients with heart failure secondary to Chagas disease. We have also demonstrated that LAV provides incremental prognostic information independent of clinical data and conventional echocardiographic parameters that predict survival.
authors.affiliation: Programa de Pós-Graduação em Ciências da Saúde, Infectologia e Medicina Tropical, Departamento de Clínica Médica, Hospital das Clínicas, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil. rochamoc@medicina.ufmg.br
authors.forename: Manoel Otávio C
authors.initials: MO
authors.lastname: Rocha
authors.forename: Maria Carmo P
authors.initials: MC
authors.lastname: Nunes
authors.forename: Antonio L
authors.initials: AL
authors.lastname: Ribeiro
mesh_terms: D002598:Chagas Cardiomyopathy / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology; D002908:Chronic Disease; D004562:Electrocardiography; D006333:Heart Failure / Q000503:physiopathology; D006801:Humans; D011379:Prognosis; D014463:Ultrasonography; D018754:Ventricular Dysfunction / Q000503:physiopathology