Chagas Cardiomyopathy : Usefulness of EKG and Echocardiogram in a Non-Endemic Country
Sánchez-Montalvá, Adrián (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Salvador, Fernando (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Rodríguez Palomares, José Fernando (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Sulleiro Igual, Elena (Hospital Universitari Vall d'Hebron)
Sao-Avilés, Augusto (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Roure, Sílvia (Universitat Autònoma de Barcelona)
Valerio, Lluís (Universitat Autònoma de Barcelona)
Evangelista Masip, Arturo (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Molina Romero, Israel (Hospital Universitari Vall d'Hebron. Institut de Recerca)

Data:	2016
Resum:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Resum:	Chagas disease (CD) is a major cause of cardiomyopathy in Latin America, and migration movements have now spread the disease worldwide. However, data regarding Chagas cardiomyopathy (CC) and the usefulness of echocardiography in non endemic countries are still scarce. We selected 485 patients in the chronic phase of CD from two Spanish settings. Data from physical examination, electrocardiogram (EKG), x-ray, and two dimensional transthoracic echocardiogram were recorded. Trypanosoma cruzi DNA was assessed by PCR in peripheral blood. Patients were stratified according to the Kuschnir classification and a combination of echocardiogram and electrocardiogram findings. Patients mainly came from Bolivia (459; 94. 6%). One hundred and forty three patients (31. 5%) had at least one electrocardiogram abnormality. Twenty seven patients (5. 3%) had an abnormal echocardiography. Patients with abnormal echocardiography were older (47 (IQR 38-57) years vs 41 (IQR 38-57) years); p = 0. 019) and there was a greater proportion of males (66. 7% vs 29. 7%); p<0. 001). Among echocardiographic variables, diastolic dysfunction was associated with poor cardiac status. In the multivariate analysis, abnormal EKG and gender were associated with abnormal echocardiography. Echocardiography may be spared for males under 30 and females under 45 years old with normal EKG as the likelihood of having an abnormal echocardiography is minimal. Association between T. cruzi DNA in the peripheral blood and cardiac involvement was not observed. CC rates in the studied population are low. Age and sex are important determinants for the development of CC, and with the EKG should guide echocardiogram performance540 __.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	PloS one, Vol. 11 (june 2016) , ISSN 1932-6203

DOI: 10.1371/journal.pone.0157597
PMID: 27308824

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