title: Prognostic value of exercise-induced ventricular arrhythmia in Chagas' heart disease.
abstract: OBJECTIVE
  To determine the prevalence and the prognostic value of exercise-induced ventricular arrhythmia (EIVA) in chronic Chagas' heart disease.
  
  
  METHODS
  An open prospective cohort of 130 clinically stable patients at a University Hospital outpatient unit in Rio de Janeiro, Brazil, was followed up at scheduled clinical visits from 1990 through 2007. The endpoint was total cardiovascular mortality. Survival curves (Kaplan-Meier) and a multivariate Cox proportional hazard model were adjusted to determine the association between EIVA and mortality.
  
  
  RESULTS
  The median duration of follow-up was 9.9 years (range, 132 days to 17 years). EIVA prevalence was 43.1% (95% CI: 34.5-51.7). Thirty-three cardiovascular deaths (25.4%) occurred. The hazard ratio of EIVA for cardiovascular death, after adjustment for age, was 1.84 (P = 0.09). An interaction was found between EIVA and cardiomegaly on x-ray. In the group with cardiomegaly, the hazard of dying was four times greater in the presence of EIVA (P for interaction = 0.05).
  
  
  CONCLUSIONS
  In clinically stable chagasic subjects with cardiomegaly, EIVA is a clinically significant marker of total cardiovascular mortality and may be a useful risk stratification tool in this population.
authors.affiliation: Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Brazil. coury@hucff.ufrj.br
authors.forename: Roberto Coury
authors.initials: RC
authors.lastname: Pedrosa
authors.forename: José Hugo Gameiro
authors.initials: JH
authors.lastname: Salles
authors.forename: Monica M F
authors.initials: MM
authors.lastname: Magnanini
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Bezerra
authors.forename: Katia Vergetti
authors.initials: KV
authors.lastname: Bloch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D009202:Cardiomyopathies; D014355:Chagas Disease / Q000175:diagnosis* / Q000401:mortality*; D015897:Comorbidity; D004562:Electrocardiography / Q000706:statistics & numerical data*; D005080:Exercise Test / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D015996:Survival Rate; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000401:mortality*