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open access

Vol 29, No 1 (2022)
Original Article
Submitted: 2019-12-26
Accepted: 2020-03-09
Published online: 2020-03-18
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Does left ventricular reverse remodeling influence long-term outcomes in patients with Chagas cardiomyopathy?

Marcelo Arruda Nakazone12, Ana Paula Otaviano3, Maurício Nassau Machado2, Reinaldo Bulgarelli Bestetti14
DOI: 10.5603/CJ.a2020.0038
·
Pubmed: 32207838
·
Cardiol J 2022;29(1):44-52.
Affiliations
  1. Postgraduate Division, São José do Rio Preto Medical School, São José do Rio Preto, SP, Brazil
  2. Hospital de Base, Fundação Faculdade Regional de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brazil
  3. Hospital das Clínicas, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
  4. University of Ribeirão Preto, Ribeirão Preto, SP, Brazil

open access

Vol 29, No 1 (2022)
Original articles — Clinical cardiology
Submitted: 2019-12-26
Accepted: 2020-03-09
Published online: 2020-03-18

Abstract

Background: The impact of left ventricular reverse remodeling (LVRR) on the prognosis of Chagas cardiomyopathy is unknown. The aim of this study was to determine whether the presence of LVRR can predict mortality in these patients.
Methods: From January 2000 to December 2010, the medical charts of 159 patients were reviewed. LVRR was defined as an increase of left ventricular ejection fraction (LVEF) and a decrease of left ventricular end-diastolic diameter (LVDD) by two-dimensional echocardiography. No patient underwent cardiac resynchronization therapy or required mechanical ventricular assistance.
Results: At baseline, median (25th–75th) LVDD was 64 mm (59–70), and median LVEF was 33.2% (26.4–40.1). LVRR was detected in 24.5% of patients in a 40-month (26–64) median follow-up. In the LVRR group, LVDD decreased from 64 mm (59–68) to 60 mm (56–65; p < 0.001), and LVEF increased from 31.3% (24.1–39.0) to 42.5% (32.2–47.7; p < 0.001). However, LVRR was not associated with heart failure hospitalization, cardiogenic shock, heart transplantation, or mortality (p > 0.05 for all comparisons). The Cox proportional hazard model analysis identified only cardiogenic shock (hazard ratio [HR]: 2.41; 95% confidence interval [CI]: 1.51–3.85; p < 0.001) and serum sodium level (HR: 0.91; 95% CI: 0.86–0.96; p < 0.001) as independent predictors of all-cause mortality.
Conclusions: Left ventricular reverse remodeling occurs in one quarter of patients with Chagas cardiomyopathy and have no impact on the outcomes of patients with this condition.

Abstract

Background: The impact of left ventricular reverse remodeling (LVRR) on the prognosis of Chagas cardiomyopathy is unknown. The aim of this study was to determine whether the presence of LVRR can predict mortality in these patients.
Methods: From January 2000 to December 2010, the medical charts of 159 patients were reviewed. LVRR was defined as an increase of left ventricular ejection fraction (LVEF) and a decrease of left ventricular end-diastolic diameter (LVDD) by two-dimensional echocardiography. No patient underwent cardiac resynchronization therapy or required mechanical ventricular assistance.
Results: At baseline, median (25th–75th) LVDD was 64 mm (59–70), and median LVEF was 33.2% (26.4–40.1). LVRR was detected in 24.5% of patients in a 40-month (26–64) median follow-up. In the LVRR group, LVDD decreased from 64 mm (59–68) to 60 mm (56–65; p < 0.001), and LVEF increased from 31.3% (24.1–39.0) to 42.5% (32.2–47.7; p < 0.001). However, LVRR was not associated with heart failure hospitalization, cardiogenic shock, heart transplantation, or mortality (p > 0.05 for all comparisons). The Cox proportional hazard model analysis identified only cardiogenic shock (hazard ratio [HR]: 2.41; 95% confidence interval [CI]: 1.51–3.85; p < 0.001) and serum sodium level (HR: 0.91; 95% CI: 0.86–0.96; p < 0.001) as independent predictors of all-cause mortality.
Conclusions: Left ventricular reverse remodeling occurs in one quarter of patients with Chagas cardiomyopathy and have no impact on the outcomes of patients with this condition.

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Keywords

left ventricular remodeling, heart failure, Chagas cardiomyopathy, prognosis, mortality

About this article
Title

Does left ventricular reverse remodeling influence long-term outcomes in patients with Chagas cardiomyopathy?

Journal

Cardiology Journal

Issue

Vol 29, No 1 (2022)

Article type

Original Article

Pages

44-52

Published online

2020-03-18

Page views

5853

Article views/downloads

1012

DOI

10.5603/CJ.a2020.0038

Pubmed

32207838

Bibliographic record

Cardiol J 2022;29(1):44-52.

Keywords

left ventricular remodeling
heart failure
Chagas cardiomyopathy
prognosis
mortality

Authors

Marcelo Arruda Nakazone
Ana Paula Otaviano
Maurício Nassau Machado
Reinaldo Bulgarelli Bestetti

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