title: Repolarization parameters are associated with mortality in chagas disease patients in the United States.
abstract: OBJECTIVE
  The goal of this study was to examine the association between ECG repolarization parameters and mortality in Chagas disease (CD) patients living in the United States.
  
  
  METHODS
  CD patients with cardiomyopathy (CM) and bundle branch block (BBB) or BBB alone were compared to age- and sex-matched controls. QT interval, QT dispersion (QTd), T wave peak to T wave end duration (Tp-Te) and T wave peak to T wave end dispersion ((Tp-Te)d) were measured. Presence of fractionated QRS (fQRS) was also assessed. The main outcome measure was the association between ECG parameters and mortality or need for cardiac transplant.
  
  
  RESULTS
  A total of 18 CM and 13 BBB CD patients were studied with 97% originating from Mexico or Central America. QTd (60.0±15.0 ms vs 43.5±9.8 ms, P=0.0002), Tp-Te (102.6±29.3 ms vs 77.1±11.0 ms, P=0.0002) and (Tp-Te)d (39.5±9.4 ms vs 22.7±7.6 ms, P<0.0001) were prolonged in CD CM patients compared to CM controls. Chagas CM patients had more fQRS then controls (84.2±0.10% vs 33.3±0.11%, p=0.0005). QTd (59.9±15.0 ms vs 29.5±6.9 ms, P=0.0001) and (Tp-Te)d (40.0±15.9 ms vs 18.5±5.4 ms, p<0.0001) were longer in the CD BBB group compared to BBB controls. Univariate analysis showed QTd (56.9±15.0 ms vs 46.5±17.3 ms, p=0.0412) and (Tp-Te)d (36.8±13.5 ms vs 28.5±13.3 ms, p=0.0395) were associated with death and/or need for cardiac transplant.
  
  
  CONCLUSIONS
  Our results indicate that P-max and PD are useful electrocardiographic markers for identifying the β-TM-high-risk patients for AF onset, even when the cardiac function is conserved.
authors: Center of Excellence for the Treatment of Chagas Disease, Olive View-UCLA Medical Center, Sylmar, CA ; UCLA Cardiac Arrhythmia Center, Ronald Reagan UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA.
authors: Jason
authors: J
authors: Bradfield
authors: Center of Excellence for the Treatment of Chagas Disease, Olive View-UCLA Medical Center, Sylmar, CA.
authors: Brandon
authors: B
authors: Woodbury
authors: Center of Excellence for the Treatment of Chagas Disease, Olive View-UCLA Medical Center, Sylmar, CA.
authors: Mahmoud
authors: M
authors: Traina
authors: Center of Excellence for the Treatment of Chagas Disease, Olive View-UCLA Medical Center, Sylmar, CA.
authors: Salvador
authors: S
authors: Hernandez
authors: Center of Excellence for the Treatment of Chagas Disease, Olive View-UCLA Medical Center, Sylmar, CA.
authors: Daniel
authors: D
authors: Sanchez
authors: Center of Excellence for the Treatment of Chagas Disease, Olive View-UCLA Medical Center, Sylmar, CA.
authors: Robin
authors: R
authors: Wachsner
authors: UCLA Cardiac Arrhythmia Center, Ronald Reagan UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA.
authors: Kalyanam
authors: K
authors: Shivkumar
authors: Center of Excellence for the Treatment of Chagas Disease, Olive View-UCLA Medical Center, Sylmar, CA.
authors: Sheba
authors: S
authors: Meymandi
keywords: Chagas Disease; Mortality; Repolarization Parameters