Echocardiography (Mount Kisco, N.Y.) · 2025
Predictors of Incident Heart Failure in Patients With Chronic Chagas Disease Cardiomyopathy.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Cunha Danton Machado da, Mediano Mauro Felippe Felix, Rimolo Lorena Dos Santos Marreto, da Costa Andréa Rodrigues, Diogo Danilo Bento, Sangenis Luiz Henrique Conde, Veloso Henrique Horta, de Holanda Marcelo Teixeira, Hasslocher-Moreno Alejandro Marcel, Cunha Ademir Batista da, Saraiva Roberto Magalhães
Аннотация
PURPOSE: Patients with chronic Chagas cardiomyopathy (CCC) have a high mortality due to heart failure (HF). The aim of this study was to investigate clinical and echocardiographic predictors of incident HF in patients with CCC.
METHODS: Single-center retrospective longitudinal observational study which included 176 adult patients (59.1% women; 53.9 ± 10 years old; mean left ventricular [LV] ejection fraction 62% ± 10%) at an early stage of CCC (electrocardiogram and/or wall motion changes but no HF). The primary outcome was incident HF. The association between studied parameters with incident HF was performed by competing-risk survival regression models using the Fine and Gray method.
RESULTS: After a mean follow-up of 8.8 ± 3.6 years, 42 patients progressed to HF (27.04 cases/1000 patient-years). A model 0 adjusted for clinical and 2D-Doppler echocardiographic parameters and for all-cause mortality revealed diabetes mellitus (HR 4.91, 95% CI 1.67-14.4, p = 0.004), LV ejection fraction (HR 0.96, 95% CI 0.93-0.99, p = 0.022), and E' velocity (HR 0.79, 95% CI 0.67-0.95, p = 0.01) as independently associated with incident HF. The addition of strain-derived parameters to model 0 revealed that LV global circumferential strain (HR 0.83, 95% CI 0.78-0.89, p < 0.001) and left atrial booster contraction strain (HR 1.14, 95% CI 1.02-1.28, p = 0.022) were associated with incident HF.
CONCLUSION: While most clinical parameters were not associated with incident HF in patients with CCC, echocardiographic parameters, including LV systolic and diastolic function and strain-derived parameters, were associated with incident HF in patients with CCC. This knowledge can be very useful for planning the care and follow-up of these patients.
METHODS: Single-center retrospective longitudinal observational study which included 176 adult patients (59.1% women; 53.9 ± 10 years old; mean left ventricular [LV] ejection fraction 62% ± 10%) at an early stage of CCC (electrocardiogram and/or wall motion changes but no HF). The primary outcome was incident HF. The association between studied parameters with incident HF was performed by competing-risk survival regression models using the Fine and Gray method.
RESULTS: After a mean follow-up of 8.8 ± 3.6 years, 42 patients progressed to HF (27.04 cases/1000 patient-years). A model 0 adjusted for clinical and 2D-Doppler echocardiographic parameters and for all-cause mortality revealed diabetes mellitus (HR 4.91, 95% CI 1.67-14.4, p = 0.004), LV ejection fraction (HR 0.96, 95% CI 0.93-0.99, p = 0.022), and E' velocity (HR 0.79, 95% CI 0.67-0.95, p = 0.01) as independently associated with incident HF. The addition of strain-derived parameters to model 0 revealed that LV global circumferential strain (HR 0.83, 95% CI 0.78-0.89, p < 0.001) and left atrial booster contraction strain (HR 1.14, 95% CI 1.02-1.28, p = 0.022) were associated with incident HF.
CONCLUSION: While most clinical parameters were not associated with incident HF in patients with CCC, echocardiographic parameters, including LV systolic and diastolic function and strain-derived parameters, were associated with incident HF in patients with CCC. This knowledge can be very useful for planning the care and follow-up of these patients.