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2015 ; 10
(3
): 159-66
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Electrocardiographic and echocardiographic abnormalities in Chagas disease:
findings in residents of rural Bolivian communities hyperendemic for Chagas
disease
#MMPMID26407511
Fernandez AB
; Nunes MC
; Clark EH
; Samuels A
; Menacho S
; Gomez J
; Bozo Gutierrez RW
; Crawford TC
; Gilman RH
; Bern C
Glob Heart
2015[Sep]; 10
(3
): 159-66
PMID26407511
show ga
BACKGROUND: Chagas disease is a neglected and preventable tropical disease that
causes significant cardiac morbidity and mortality in Latin America. OBJECTIVES:
This study sought to describe cardiac findings among inhabitants of rural
communities of the Bolivian Chaco. METHODS: The cardiac study drew participants
from an epidemiologic study in 7 indigenous Guarani communities. All infected
participants 10 years or older were asked to undergo a brief physical examination
and 12-lead electrocardiogram (ECG). A subset had echocardiograms. ECG and
echocardiograms were read by 1 or more cardiologists. RESULTS: Of 1,137 residents
10 years or older, 753 (66.2%) had Trypanosoma cruzi infection. Cardiac
evaluations were performed for 398 infected participants 10 years or older.
Fifty-five participants (13.8%) had 1 or more ECG abnormalities suggestive of
Chagas cardiomyopathy. The most frequent abnormalities were bundle branch blocks
in 42 (11.3%), followed by rhythm disturbances or ventricular ectopy in 13
(3.3%), and atrioventricular blocks (AVB) in 10 participants (2.6%). The
prevalence of any abnormality rose from 1.1% among those 10 to 19 years old to
14.2%, 17.3%, and 26.4% among those 20 to 39, 40 to 59, and older than 60 years,
respectively. First-degree AVB was seen most frequently in participants 60 years
or older, but the 4 patients with third-degree AVB were all under 50 years old.
Eighteen and 2 participants had a left ventricular ejection fraction of 40% to
54% and <40%, respectively. An increasing number of ECG abnormalities was
associated with progressively larger left ventricular end-diastolic dimensions
and lower left ventricular ejection fraction. CONCLUSIONS: We found a high
prevalence of ECG abnormalities and substantial evidence of Chagas
cardiomyopathy. Programs to improve access to basic cardiac care (annual ECG,
antiarrhythmics, pacemakers) could have an immediate impact on morbidity and
mortality in these highly endemic communities.