Introduction: Heart failure (HF) represents the final stage of chronic chagasic cardiomyopathy (CChC). The diagnosis of CChC is based on the demonstration of anti-Trypanosoma cruzi antibodies (aTcAg) and clinical and epidemiological data. In Venezuela, there are no data about the prevalence of chagasic HF. The aim of this study was to determine the epidemiological, clinical, and inflammatory risk factors associated with seronegative or seropositive HF patients. Methods: We performed a cross-sectional study in the Venezuelan central-west states among a healthy rural population and in patients admitted to the emergency room with uncompensated HF. Results: The seroprevalence rates of Trypanosoma cruzi antibodies were 11.2% and 40.1% in the healthy population and in HF patients, respectively. Seropositivity in healthy individuals was associated with age, knowledge on triatomine vectors, and having seen wild reservoirs in the house; in HF patients, with contact with the vector and previous clinical diagnosis of Chagas' disease; and in both groups taken together, with age, knowledge on triatomines, and HF. Seropositive patients had prolonged QRS, decreased ejection fraction, and high serum magnesium, all significant as compared with HF seronegative cases. Left atrium enlargement and ventricular hypertrophy were most frequently observed in HF seronegative patients. CRP, IL6, ILβ1, IL2, and FNTα were elevated in 94.5%, 48%, 17.8%, 13.7%, and 6.9% of HF patients, respectively, but only IL2 levels were associated with chagasic HF. Conclusions: There is a high prevalence of aTcAg in HF patients from the central-west region of Venezuela, and their epidemiological, clinical, and inflammatory features are discreetly different as compared with those of seronegative cases.
decena de variables a lo largo del ciclo económico para distintas ciudades y grupos demográficos. Las fechas utilizadas para identificar las fases de recesión fueron tomadas de Alfonso et al. (2013). Se encuentra que la participación laboral aumenta en las contracciones mientras que la tasa de ocupación cae. La suma de estos dos hechos permite predecir sin ambigüedades que en las recesiones el desempleo aumenta. En particular, los cesantes, más que los aspirantes, siempre aumentan en los momentos de crisis; es decir, los despidos y la reinserción al mercado parecen ser los eventos más regulares durante los períodos de crisis. Los salarios y las horas trabajadas caen en las recesiones mientras que el subempleo por horas aumenta. La relación de asalariados a población en edad de trabajar se constituye en una variable clave para el estudio de las fases del ciclo ya que siempre se contrae durante las recesiones. Palabras clave: ciclos económicos, tasa de participación, tasa de ocupación, tasa de desempleo, salarios. Clasificación JEL: J0, E3. Las opiniones expresadas en este documento son responsabilidad exclusiva de los autores y no comprometen ni al Banco de la República ni a su Junta Directiva. Los errores son también su responsabilidad exclusiva.
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