Subject(s)
Cardiac Pacing, Artificial/statistics & numerical data , Chagas Cardiomyopathy/mortality , Chagas Cardiomyopathy/therapy , Heart Failure, Systolic , Ventricular Function, Right/physiology , Adult , Aged , Cardiac Pacing, Artificial/methods , Chronic Disease , Female , Heart Failure, Systolic/mortality , Heart Failure, Systolic/parasitology , Heart Failure, Systolic/therapy , Humans , Male , Middle Aged , Predictive Value of Tests , PrevalenceSubject(s)
Adrenergic beta-Antagonists/pharmacology , Autonomic Nervous System/physiopathology , Autonomic Nervous System/parasitology , Chagas Cardiomyopathy/drug therapy , Chagas Cardiomyopathy/physiopathology , Heart Failure, Systolic/drug therapy , Heart Failure, Systolic/parasitology , Angiotensin-Converting Enzyme Inhibitors/pharmacology , Animals , Chronic Disease , Heart Failure, Systolic/physiopathology , HumansABSTRACT
BACKGROUND AND AIMS: We sought to identify predictors of all-cause mortality for Chagas' disease patients with chronic systolic heart failure because they are virtually lacking in the current era of heart failure therapy. METHODS AND RESULTS: This study focus on 127 patients with the diagnosis of chronic systolic heart failure secondary to Chagas' cardiomyopathy. Mean follow up was 25+/-19 months. Sixty-three (50%) patients died during the study period. Cox regression analysis showed lack of B-blocking agent use (p=0.002, hazard ratio=0.30, 95% Confidence Interval 0.14 to 0.64), serum sodium levels (p=0.01, hazard ratio=0.93, 95% Confidence Interval 0.87 to 0.98), left ventricular ejection fraction (p=0.02, hazard ratio=0.96, 95% Confidence Interval 0.93 to 0.99), digoxin treatment (p=0.04, hazard ratio=8.47, 95% Confidence Interval 1.13 to 62.52) and New York Heart Association Class IV on admission (p=0.034, hazard ratio=1.92, 95% Confidence Interval 1.02 to 3.51) independent predictors of all-cause mortality. CONCLUSION: Lack of B-blocking agent use, serum sodium levels, left ventricular ejection fraction, digoxin treatment and New York Heart Association Class IV are independent predictors of all-cause mortality for patients with chronic heart failure secondary to Chagas' cardiomyopathy in the current era of heart failure therapy.
