Prognostic Value of Exercise-Induced Ventricular Arrhythmia in Chagas’ Heart Disease

Authors


  • Conflicts of interest: There are no potential conflicts of interest.

  • This study was partially supported by Fundação de Amparo a Pesquisa do Rio de Janeiro—FAPERJ and by Conselho Nacional de Pesquisa—CNPq.

Address for reprints: Roberto Coury Pedrosa, Serviço de Cardiologia, Hospital Universitário Clementino Fraga Filho—UFRJ, Rua Prof. Rodolpho Paulo Rocco, No. 255, Cidade Universitária-Ilha do Fundão, Rio de Janeiro CEP 21941-913, RJ, Brazil. Fax: 55-21-2562-2618; e-mail: coury@hucff.ufrj.br

Abstract

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)

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