Conflicts of interest: There are no potential conflicts of interest.
Prognostic Value of Exercise-Induced Ventricular Arrhythmia in Chagas’ Heart Disease
Article first published online: 28 JUL 2011
©2011, The Authors. Journal compilation ©2011 Wiley Periodicals, Inc.
Pacing and Clinical Electrophysiology
Volume 34, Issue 11, pages 1492–1497, November 2011
How to Cite
PEDROSA, R. C., SALLES, J. H. G., MAGNANINI, M. M. F., BEZERRA, D. C. and BLOCH, K. V. (2011), Prognostic Value of Exercise-Induced Ventricular Arrhythmia in Chagas’ Heart Disease. Pacing and Clinical Electrophysiology, 34: 1492–1497. doi: 10.1111/j.1540-8159.2011.03171.x
This study was partially supported by Fundação de Amparo a Pesquisa do Rio de Janeiro—FAPERJ and by Conselho Nacional de Pesquisa—CNPq.
- Issue published online: 9 NOV 2011
- Article first published online: 28 JUL 2011
- Received January 18, 2011; revised May 16, 2011; accepted May 20, 2011.
- Chagas’ heart disease;
- ventricular arrhythmias;
- exercise test
Objective: To determine the prevalence and the prognostic value of exercise-induced ventricular arrhythmia (EIVA) in chronic Chagas’ heart disease.
Study Design and Setting: An open prospective cohort of 130 clinically stable patients at a University Hospital outpatient unit in Rio de Janeiro, Brazil, was followed up at scheduled clinical visits from 1990 through 2007. The endpoint was total cardiovascular mortality. Survival curves (Kaplan-Meier) and a multivariate Cox proportional hazard model were adjusted to determine the association between EIVA and mortality.
Results: The median duration of follow-up was 9.9 years (range, 132 days to 17 years). EIVA prevalence was 43.1% (95% CI: 34.5–51.7). Thirty-three cardiovascular deaths (25.4%) occurred. The hazard ratio of EIVA for cardiovascular death, after adjustment for age, was 1.84 (P = 0.09). An interaction was found between EIVA and cardiomegaly on x-ray. In the group with cardiomegaly, the hazard of dying was four times greater in the presence of EIVA (P for interaction = 0.05).
Conclusion: In clinically stable chagasic subjects with cardiomegaly, EIVA is a clinically significant marker of total cardiovascular mortality and may be a useful risk stratification tool in this population. (PACE 2011; 34:1492–1497)