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10.1016/j.gheart.2015.07.004

http://scihub22266oqcxt.onion/10.1016/j.gheart.2015.07.004
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suck abstract from ncbi


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pmid26407511      Glob+Heart 2015 ; 10 (3): 159-66
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  • Electrocardiographic and echocardiographic abnormalities in residents of rural Bolivian communities hyperendemic for Chagas disease #MMPMID26407511
  • Fernandez AB; Nunes MCP; Clark EH; Samuels A; Menacho S; Gomez J; Gutierrez RWB; Crawford TC; Gilman RH; Bern C
  • Glob Heart 2015[Sep]; 10 (3): 159-66 PMID26407511show ga
  • Background: Chagas disease is a neglected and preventable tropical disease that causes significant cardiac morbidity and mortality in Latin America. Our objective in this study was 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. A subset had echocardiograms (ECGs). ECGs and echocardiograms were read by one or more cardiologists. Results: Of 1137 residents 10 years or older, 753 (66.2%) had T. cruzi infection. Cardiac evaluations were performed for 398 infected participants 10 years or older. Fifty-five (13.8%) participants had one or more ECG abnormality 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 (2.6%) participants. The prevalence of any abnormality rose from 1.1% among those 10-19 years old to 14.2%, 17.3% and 26.4% among those 20-39, 40-59 and older than 60 years, respectively. First degree AVB was seen most frequently in participants 60 years or older, but the 4 patients with 3rd degree AVB were all under 50 years old. Eighteen and two participants had a left ventricular ejection fraction of 40-54% 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 ECGs, antiarrhythmics, pacemakers) could have an immediate impact on morbidity and mortality in these highly endemic communities.
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