[Chagas cardiomyopathy: prognosis in clinical and hemodynamic profile C].
BACKGROUND
patients with heart failure (HF) who are admitted showing poor perfusion and congestion (clinical-hemodynamic profile C) are the group that evolves with the worst prognosis in decompensated heart failure. However, there is little information in literature on the etiology of cardiopathy influences the outcome of patients in advanced stage.


OBJECTIVE
to assess the outcome of patients admitted with clinical and hemodynamic profile C and verify the role of the etiology in this phase.


METHODS
a cohort study was performed including patients with left ventricle ejection fraction (LVEF) < 45.0%, functional class IV and hospitalization presenting clinical-hemodynamic profile C. The group was divided into patients with chagasic (Ch) and non chagasic (NCh) cardiomyopathy. Statistical analysis used Student t test, Fisher exact test, chi-square and SPSS tests. The significance of p < 0.05 was considered.


RESULTS
one hundred patients, with mean age 57.6 ± 15.1 years and mean LVEF of 23.8 ± 8.5%, were included. Among the patients studied, 33.0% were chagasic and, in comparison with NCh, had lower systolic blood pressure (Ch 89.3 ± 17.1 mmHg versus NCh 98.8 ± 21.7 mmHg, p = 0.03 ) and lowest average age - Ch 52.9 ± 14.5 years versus NCh 59.8 ± 14.9 years, p = 0.03). During follow-up of 25 months, mortality was 66.7% for Ch and 37.3% in NCh (p = 0.019). The Chagas disease etiology was an independent marker of poor prognosis in multivariate analysis with risk ratio of 2.75 (HF 95.0%, from 1.35 to 5.63).


CONCLUSIONS
in patients with advanced HF, Chagas disease is an important predictor of the worst prognosis.
Cardoso
Juliano
J
InCor Hospital de Cotoxó, HCFMUSP, São Paulo, SP, Brasil. julianonc@cardiol.br
Novaes
Milena
M
Ochiai
Marcelo
M
Regina
Kelly
K
Morgado
Paulo
P
Munhoz
Robinson
R
Brancalhão
Euler
E
Lima
Marcelo
M
Barretto
Antonio Carlos Pereira
AC
D002598:Chagas Cardiomyopathy / Q000401:mortality / Q000503:physiopathology*; D018450:Disease Progression; D004812:Epidemiologic Methods; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis