Acute Heart Failure in Patients with Chagas Cardiomyopathy: Results of the I Brazilian Heart Failure Registry (BREATHE).
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Silva Pedro Gabriel Melo de Barros E, Albuquerque Denilson Campos, Lopes Renato Delascio, Nogueira Paulo Roberto, Freitas Aguinaldo F, Nascimento Carlos Vieira, Mady Charles, Santos Elizabete Silva Dos, Hernandes Mauro Esteves, Rivera Maria Alayde Mendonça, Souza Neto João David de, Rabelo Alvaro, Canesin Manoel Fernandes, Reis Helder, Armstrong Anderson da Costa, Hoffmann Conrado, Santos Renato Hideo Nakagawa, Jesuino Isabella de Andrade, Rohde Luis Eduardo, Moura Lidia Zytinsky, Marcondes-Braga Fabiana Goulart, Mesquita Evandro Tinoco, Figueiredo Neto José Albuquerque de, Mourilhe-Rocha Ricardo, Beck-da-Silva Luís, Oliveira Junior Mucio Tavares, Simões Marcus Vinicius
Аннотация
OBJECTIVES: The current analysis reports the results of the I Brazilian Heart Failure Registry (BREATHE) assessing baseline characteristics and clinical outcomes of patients with acute heart failure due to CCC.
METHODS: BREATHE enrolled a total of 3,013 adult patients hospitalized with acute heart failure. We analyzed comparatively 261 (8.7%) patients with chronic CCC and 2,752 (91.3%) patients with other etiologies. Clinical and demographic information, cardiac structure/function data on echocardiogram and outcomes during the hospital stay and after discharge were assessed in both groups. Uni and multivariate tests were performed and a p-value <0.05 was considered statistically significant.
RESULTS: Patients with CCC presented lower systolic blood pressure (108.3 ± 26.1 vs 128.3 ± 30.3 mmHg, p<0.001) and left ventricle ejection fraction (25.4 [19 - 36]% vs 37 [27 - 54] %, p<0.001) with higher rates of jugular vein distension (54.8% vs 38.9%, p<0.001), hepatomegaly (47.9% vs 25.6%, p<0.001), and "cold and wet" clinical hemodynamic profile (27.2% vs 10.6%, p<0.001). Patients with CCC presented higher rate of the composite death or heart transplantation (17.4% vs. 11.1%, p=0.004), and higher cumulative incidence of death after 3 months (16.5% vs 10.8%, p=0.017), 6 months (25.3% vs 17.2%, p=0.006), and 12 months (39.4% vs 26.6%, p<0.001). Besides, CCC was independently associated with 12-month mortality risk with odds ratio = 2.02 (95% IC: 1.47-2.77).
CONCLUSION: Patients with CCC, hospitalized due to acute heart failure, in comparison to other etiologies, presented a higher risk profile that was associated with a poorer outcome during hospital stay and after discharge.