Heart Failure Survival Score in Patients With Chagas Disease: Correlation With Functional Variables

Ritt, Luiz Eduardo Fonteles; Carvalho, Antônio Carlos; Feitosa, Gílson Soares; Pinho-Filho, Joel Alves; Macedo, Cristiano; Vilas-Boas, Fábio; Andrade, Marcus Vinicius Santos; Feitosa-Filho, Gilson Soares; Almeida, Andréa Sobral de; Barojas, Marcos; Lópes, Renato D.

doi:10.1016/j.rec.2011.12.020

Cited by 7 publications

(9 citation statements)

References 29 publications

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“…Oxygen pulse is a CPET variable that can be used as an indirect indicator of LV stroke volume [19], and its association with prognosis in ChC remains uncertain. While Souza et al (2015) found no association between oxygen pulse and death in 2 years [48], Ritt et al (2012) found a correlation between heart failure survival score (a validated prognostic score for HF patients) and oxygen pulse [49]. In our study, this variable presented an inverse association, decreasing the risk of death during the CRP in about 30%.…”

Section: Discussioncontrasting

confidence: 45%

Factors related to the discontinuation and mortality rates of a cardiac rehabilitation programme in patients with Chagas disease: a 6‐year experience in a Brazilian tertiary centre

Vieira

Mendes

Mazzoli‐Rocha

et al. 2021

Tropical Med Int Health

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Objectives To describe the clinical and sociodemographic characteristics of participants as well as discontinuation and mortality rates in a cardiac rehabilitation programme (CRP) tailored to Chagas disease (CD). Methods Participants underwent functional capacity, anthropometry and cardiac function evaluations before beginning a CRP. Univariate and multivariate Cox proportional hazards models were performed to investigate the associations between clinical and sociodemographic characteristics at baseline with discontinuation rates and deaths. Results Forty‐two patients were enrolled in the CRP (61.9% men, mean age of 58.1 ± 11.8 years). During a median follow‐up period of 10.8 months, 74% discontinued and 14% died while enrolled in CRP. 34% of the patients who discontinued CRP died during follow‐up. White race (HR = 0.09; 95% CI 0.01–1.00), right ventricular systolic dysfunction (HR = 10.54; 95% CI 1.24–89.50) and oxygen pulse (HR = 0.69; 95% CI 0.48–0.99) were independently associated with death while enrolled in CRP. Married status (HR = 0.44; 95% CI 0.21–0.95) was independently associated with discontinuation rates from CRP. VO2 peak (HR = 0.85; 95% CI 0.74–0.98) and CRP discontinuation due to CD‐related reasons (HR = 8.33; 95% CI 1.91–36.27) were the variables independently associated with death after discontinuation of CRP. Conclusion In this population, sociodemographic aspects and severity of CD were important determinants of CRP discontinuation and mortality.

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Section: Discussioncontrasting

confidence: 45%

Factors related to the discontinuation and mortality rates of a cardiac rehabilitation programme in patients with Chagas disease: a 6‐year experience in a Brazilian tertiary centre

Vieira

Mendes

Mazzoli‐Rocha

et al. 2021

Tropical Med Int Health

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“…We studied 55 patients with HF due to Chagas disease with left ventricular dysfunction (ejection fraction [EF] b45%) and symptoms who were identified from participants in 2 randomized clinical trials [4] and followed for all-cause mortality. A detailed description of the study procedures was previously published [5]. This study was approved by the institutional review board of the Santa Izabel Hospital, Bahia, Brazil.…”

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confidence: 99%

“…In general, patients were well treated for HF: 89% took an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, 62% used beta-blockers, 86% a diuretic, and 74% an aldosterone blocker. A complete description of the baseline population characteristics was previously published [5].…”

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confidence: 99%

Cardiopulmonary exercise and 6-min walk tests as predictors of quality of life and long-term mortality among patients with heart failure due to Chagas disease

Ritt

Carvalho

Feitosa

et al. 2013

International Journal of Cardiology

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“…Previous studies have developed models to predict outcome in patients with chronic Chagas disease, 40,41 and the HFSS has been applied to patients specifically with Chagas disease heart failure as well. 42 In this context, it should be emphasized that our study does not deal with prognostication in a cohort of patients with chronic Chagas disease, but with a cohort of patients with CHF, including those with chronic Chagas disease. Therefore, the models mentioned earlier do not apply to our cohort.…”

Section: Discussionmentioning

confidence: 99%

The use of the CALL Risk Score for predicting mortality in Brazilian heart failure patients

et al. 2020

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Aims This study aimed to develop and validate a simple method for predicting long-term all-cause mortality in ambulatory patients with chronic heart failure (CHF) residing in an area where Chagas disease is endemic, which will be important not only for patients living in Latin America but also to those living in developed non-endemic countries. Methods and results A total of 677 patients with a wide spectrum of aetiologies for left ventricular systolic dysfunction and receiving optimized evidence-based treatment for CHF were prospectively followed for approximately 11 years. We established a risk score using Cox proportional hazard regression models. After multivariable analysis, four variables were independently associated with mortality and included in the CALL Risk Score: Chagas cardiomyopathy aetiology alone [hazard ratio, 3.36; 95% confidence interval (CI), 2.61-4.33; P < 0.001], age ≥60 years (hazard ratio, 1.36; 95% CI, 1.06-1.74; P = 0.016), left anterior fascicular block (hazard ratio, 1.64; 95% CI, 1.27-2.11; P < 0.001), and left ventricular ejection fraction <40% (hazard ratio, 1.73; 95% CI, 1.30-2.28; P < 0.001). The internal validation considered the bootstrapping, a resampling technique recommended for prediction model development. Hence, we established a scoring system attributing weights according to each risk factor: 3 points for Chagas cardiomyopathy alone, 1 point for age ≥60 years, and 2 points each for left anterior fascicular block and left ventricular ejection fraction <40%. Three risk groups were identified: low risk (score ≤2 points), intermediate risk (score of 3 to 5 points), and high risk (score ≥6 points). High-risk patients had more than twofold increase in mortality (26.9 events/100 patient-years) compared with intermediate-risk patients (10.1 events/100 patientyears) and almost seven-fold increase compared with low-risk patients (4.3 events/100 patient-years). The CALL Risk Score data sets from the development and internal validation cohorts both displayed suitable discrimination c-index of 0.689 (95% CI, 0.688-0.690; P < 0.001) and 0.687 (95% CI, 0.686-0.688; P < 0.001), respectively, and satisfactory calibration [Greenwood-Nam-D'Agostino test (8) = 7.867; P = 0.447] and [Greenwood-Nam-D'Agostino test (8) = 10.08; P = 0.273], respectively. Conclusions The CALL Risk Score represents a simple and validated method with a limited number of non-invasive variables that successfully predicts long-term all-cause mortality in a real-world cohort of patients with CHF. Patients with CHF stratified as high risk according to the CALL Risk Score should be monitored and aggressively managed, including those with CHF secondary to Chagas disease.

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Heart Failure Survival Score in Patients With Chagas Disease: Correlation With Functional Variables

Cited by 7 publications

References 29 publications

Factors related to the discontinuation and mortality rates of a cardiac rehabilitation programme in patients with Chagas disease: a 6‐year experience in a Brazilian tertiary centre

Factors related to the discontinuation and mortality rates of a cardiac rehabilitation programme in patients with Chagas disease: a 6‐year experience in a Brazilian tertiary centre

Cardiopulmonary exercise and 6-min walk tests as predictors of quality of life and long-term mortality among patients with heart failure due to Chagas disease

The use of the CALL Risk Score for predicting mortality in Brazilian heart failure patients

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