Life expectancy analysis in patients with Chagas' disease: prognosis after one decade (1973–1983)

Chagas' heart disease

“…A mortality rate of 82% over the 10-year follow-up period was seen in the group of 34 patients with signs of heart failure at the beginning of the study. In contrast, a 65% 10-year survival was associated with ECG abnormalities but in absence of signs of heart failure 39 .…”

“…Thus, no adequate identification of cardiac involvement is usually provided in most of the rural-based studies [27][28][29][30][31][32][33][34][35][36][37] . Conversely, in hospital-based studies the heart disease is usually well characterized, but their results can not be extended to the whole spectrum of the chagasic population 8,[38][39][40][41] . Furthermore, because of the rather protracted course of heart involvement, from the acute myocarditis to the end-stage heart failure or malignant arrhythmia, no prospective studies encompassing the whole span of the disease in sizable populations are available 7,42 .…”

“…Very few studies have described case-control populations of chagasic and non-chagasic people. Other observational investigations focused on the description and follow-up of hospital-based cohorts of chagasic patients 7,[38][39][40][41] .…”

“…Several observational studies mainly conducted in endemic areas in Brazil, Argentina and Venezuela, since the early 1940s disclosed the natural history of Chagas' heart disease 7,[26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] .…”

Sudden death in Chagas' disease

“…Supported by a wide literature review [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] , we have listed in table I the results of the major studies on causes of death and frequency of sudden death in different population subgroups of Chagas' disease. The careful analysis of these studies allowed the following conclusions: 1) sudden death, heart failure, and cerebral thromboembolism are the major causes of death in Chagas' disease; 2) the higher or lower frequency of a certain cause fundamentally depends on the characteristics of the population studied, with sudden death predominating in studies including only ambulatory patients 18,20,21,24,26,32 or patients with ventricular arrhythmias 27,30 , and pump failure predominating in those studies carried out in hospitalized patients with cardiac decompensation 17,23,29 ; and 3) even though death in chagasic patients is intrinsically associated with the degree of myocardial impairment, part of the cases of sudden death correspond to asymptomatic patients with mild electrocardiographic alterations and normal cardiac silhouette on X-ray 19,20,28 .…”