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Artigo Produção Nacional Revisado por pares
BIBTEX RIS

Stroke History and Chagas Disease Are Independent Predictors of Silent Cerebral Microembolism in Patients with Congestive Heart Failure

2010; Karger Publishers; Volume: 31; Issue: 1 Linguagem: Inglês

10.1159/000319892

ISSN

1421-9786

Autores

Pedro Antônio Pereira de Jesus, Iuri Santana Neville, Carolina Cincurá, Daniela F. Menezes, Rodrigo M. Vieira-de-Melo, Amanda Mota Lacerda, Leila C. Viana, Davidson França Pereira, Valter Ribeiro-dos-Santos, Francisco José Farias Borges dos Reis, Cristiano Macedo, Jamary Oliveira‐Filho,

Tópico(s)

Cardiovascular Function and Risk Factors

Resumo

<i>Background:</i> Chagas disease is endemic in South and Central America, where 18 million individuals are infected by <i>Trypanosoma cruzi</i>, causing congestive heart failure (CHF) and cardioembolic stroke. Transcranial Doppler (TCD) is able to detect real-time microembolic signals (MES) to the brain vessels and may represent a surrogate marker of stroke risk. We aimed to determine predictors of MES in a population of patients with CHF. <i>Methods:</i> Consecutive CHF patients from a university-based cardiomyopathy clinic underwent TCD recording of the middle cerebral artery for 60 min by a single investigator who was blinded to all clinical data including cardiomyopathy etiology. Predictors of MES were sought by multivariable logistic regression analysis. <i>Results:</i> From April 2004 to February 2009, 144 patients were studied, including 62 (44.6%) patients with Chagas disease. MES were detected in 9 (6.2%) patients and were more frequent in patients with Chagas disease than in patients with other causes of CHF (12.9 vs. 1.2%, p = 0.005). In multivariate analysis corrected for age and left-ventricular ejection fraction, predictors of MES were Chagas disease (odds ratio = 1.15, 95% confidence interval = 1.05–1.26, p = 0.004) and stroke history (odds ratio = 1.27, 95% confidence interval = 1.08–1.50, p = 0.005). <i>Conclusions:</i> Chagas disease and stroke history are risk factors for MES independent of cardiac disease severity. Other mechanisms besides structural cardiac disease may be operative, increasing embolic risk in Chagas disease.

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