Long-term control of Chagas disease in Venezuela: effects on serologic findings, electrocardiographic abnormalities, and clinical outcome.

Abstract

Additionally, we examined clinically and obtained electrocardiograms from 775 seropositive subjects. They were classified as asymptomatic (group A, n = 614) or as symptomatic, having mild-to-moderate heart symptoms (group B, n = 99) or having advanced congestive heart failure (group C, n = 62). Their electrocardiograms were compared with those of 923 seronegative subjects collected simultaneously and with published data obtained before the CCP. Comparison of the age-related rates of electrocardiographic abnormalities of seropositive individuals before and after the CCP showed that they did not differ significantly by linear regression analysis, by the Kruskal-Wallis test, or by the normal approximation to the binomial distribution. However, the proportion of symptomatic patients below 50 years of age from series collected before the CCP were significantly higher (more than 50%) than ours after the CCP (12%; p<.O0). This disparity suggests that future CCP monitoring should include both clinical and electrocardiographic assessment. Five years follow-up (mean 28 + 18 SD, range 1 to 60 months), showed survival rates at 3 years of 98.4 ± 0.6% (SE) for group A (n = 263), 87.4 3.8% for group B (n = 44), and 37.8 ± 7.8% for group C (n = 13). Although a majority of our seropositive individuals are asymptomatic and had a fair clinical outcome, survival is still poor in those presenting with heart failure. Because effective treatment for the disease is largely unsatisfactory at present, preventive CCPs should be continuously supported.

Noninvasive prognostic markers for cardiac death and ventricular arrhythmia in long-term follow-up of subjects with chronic Chagas' disease

“…These findings as predictors of cardiac mortality and arrhythmic events agree with reports by other investigators (7)(8)(9)(10)14,37).…”

Prevalence of Trypanosoma cruzi antibodies and inflammatory markers in uncompensated heart failure

“…However, left bundle branch block has been reported with high frequency in patients with Chagas disease, especially in asymptomatic cases [21][22] ; likewise, in patients with chagasic heart disease, the frequency of right bundle branch block is similar to that previously ACKNOWLEDGMENTS reported 23 . On the other hand, in Venezuela no difference between seropositive and seronegative patients has been reported in terms of the prevalence of chronic heart disease in adults from rural communities, suggesting the existence of a rural endemic chronic heart disease in this country 24 .…”

Chagas disease: morbidity profile in an endemic area of Northeastern Brazil

“…In this context, CCC is associated with a worse prognosis and a survival rate that is one-half of the rates for cardiomyopathies of non-infl ammatory etiology (e.g., dilated cardiomyopathy and ischemic heart disease) (46) . Studies in Brazil and Venezuela have also reported that higher functional classes are associated with higher mortality rates among patients with CCC (47) (48) , with sudden death, heart failure, and ischemic stroke being the main mechanisms of death in patients with ChD (49) (50) . Our findings regarding electrocardiographic changes, such as RBBB and LAFB, are in agreement with the previous studies and are the most characteristic changes of the disease in endemic areas (51) .…”