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Echocardiographic Parameters and Survival in Chagas Heart Disease with Severe Systolic Dysfunction

2014; Sociedade Brasileira de Cardiologia (SBC); Linguagem: Inglês

10.5935/abc.20140003

1678-4170

Daniela do Carmo Rassi, Marcelo Luiz Campos Vieira, Ana Lúcia Arruda, Viviane Tiemi Hotta, Rogério Gomes Furtado, Danilo Teixeira Rassi, Salvador Rassi,

Cardiomyopathy and Myosin Studies

Background: Echocardiography provides important information on the cardiac evaluation of patients with heart failure.The identification of echocardiographic parameters in severe Chagas heart disease would help implement treatment and assess prognosis.Objective: To correlate echocardiographic parameters with the endpoint cardiovascular mortality in patients with ejection fraction < 35%.Methods: Study with retrospective analysis of pre-specified echocardiographic parameters prospectively collected from 60 patients included in the Multicenter Randomized Trial of Cell Therapy in Patients with Heart Diseases (Estudo Multicêntrico Randomizado de Terapia Celular em Cardiopatias) -Chagas heart disease arm.The following parameters were collected: left ventricular systolic and diastolic diameters and volumes; ejection fraction; left atrial diameter; left atrial volume; indexed left atrial volume; systolic pulmonary artery pressure; integral of the aortic flow velocity; myocardial performance index; rate of increase of left ventricular pressure; isovolumic relaxation time; E, A, Em, Am and Sm wave velocities; E wave deceleration time; E/A and E/Em ratios; and mitral regurgitation.Results: In the mean 24.18-month follow-up, 27 patients died.The mean ejection fraction was 26.6 ± 5.34%.In the multivariate analysis, the parameters ejection fraction (HR = 1.114; p = 0.3704), indexed left atrial volume (HR = 1.033; p < 0.0001) and E/Em ratio (HR = 0.95; p = 0.1261) were excluded.The indexed left atrial volume was an independent predictor in relation to the endpoint, and values > 70.71 mL/m² were associated with a significant increase in mortality (log rank p < 0.0001).Conclusion: The indexed left atrial volume was the only independent predictor of mortality in this population of Chagasic patients with severe systolic dysfunction.