Electrocardiographic abnormalities in chagasic patients compared to the general population: A systematic review with updated meta-analysis

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of electrocardiology Pub Date : 2025-02-19 DOI:10.1016/j.jelectrocard.2025.153893

Bruno Felipe Santos de Oliveira , Cárita Victória Carvalho de Santana , Luiz Filippe Vago Pereira, Gabriele Eliza Assis, Ana Beatriz Cazé, Jackson Pedro Barros-Pereira, Rafaela Góes Bispo, Roque Aras Júnior

{"title":"Electrocardiographic abnormalities in chagasic patients compared to the general population: A systematic review with updated meta-analysis","authors":"Bruno Felipe Santos de Oliveira , Cárita Victória Carvalho de Santana , Luiz Filippe Vago Pereira, Gabriele Eliza Assis, Ana Beatriz Cazé, Jackson Pedro Barros-Pereira, Rafaela Góes Bispo, Roque Aras Júnior","doi":"10.1016/j.jelectrocard.2025.153893","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Chagas disease (CD) remains a serious public health issue. It can progress from the acute phase to the chronic phase, manifesting as a cardiomyopathy with some typical electrocardiogram abnormality.</div></div><div><h3>Objectives</h3><div>This systematic review with meta-analysis aims to evaluate the overall prevalence of cardiac arrhythmias in patients with CD and discriminative values to clinical and epidemiological variables for specific arrhythmias.</div></div><div><h3>Methods</h3><div>Articles that included the prevalence of electrocardiographic abnormalities in CD compared to other groups were searched in the following databases: MEDLINE/PubMed, Embase and Cochrane Library. The results obtained were pooled in meta-analyses</div></div><div><h3>Results</h3><div>A total of 322.608 participants from 88 studies were included. The meta-analyses with single electrocardiographic changes showed a significant association with positive CD serology compared to non-chagasic individuals, (OR: 2.86 95 % CI 2.53; 3.23; I<sup>2</sup> = 85 %). Significant associations were found to complete right bundle branch block [CRBBB], CRBBB + left anterior fascicular block [LAFB], first-degree atrioventricular block [AVB], incomplete right bundle branch block [IRBBB], second-degree AVB, LAFB, supraventricular ectopic beats, third-degree AVB, ventricular ectopic beats and atrial fibrillation or flutter. For the presence of a single electrocardiographic alterations, the discriminative capacity variables showed: sensitivity 0.511 (0.505, 0.517), specificity 0.622 (0.620, 0.624), Positive Predictive Value (PPV) 0.101 (0.099, 0.103), Negative Predictive Value (NPV) 0.939 (0.937, 0.940), Positive Likelihood Ratio (PLR) 1.352 (1.334, 1.370) and Negative Likelihood Ratio (NLR) 0.786 (0.776, 0.797).</div></div><div><h3>Conclusion</h3><div>Our findings show a significant association between CD and several electrocardiographic abnormalities, which highlights the need for ongoing surveillance and targeted therapeutic interventions to improve clinical outcomes for patients with chagasic cardiomyopathy.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"90 ","pages":"Article 153893"},"PeriodicalIF":1.3000,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of electrocardiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0022073625000214","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction

Chagas disease (CD) remains a serious public health issue. It can progress from the acute phase to the chronic phase, manifesting as a cardiomyopathy with some typical electrocardiogram abnormality.

Objectives

This systematic review with meta-analysis aims to evaluate the overall prevalence of cardiac arrhythmias in patients with CD and discriminative values to clinical and epidemiological variables for specific arrhythmias.

Methods

Articles that included the prevalence of electrocardiographic abnormalities in CD compared to other groups were searched in the following databases: MEDLINE/PubMed, Embase and Cochrane Library. The results obtained were pooled in meta-analyses

Results

A total of 322.608 participants from 88 studies were included. The meta-analyses with single electrocardiographic changes showed a significant association with positive CD serology compared to non-chagasic individuals, (OR: 2.86 95 % CI 2.53; 3.23; I² = 85 %). Significant associations were found to complete right bundle branch block [CRBBB], CRBBB + left anterior fascicular block [LAFB], first-degree atrioventricular block [AVB], incomplete right bundle branch block [IRBBB], second-degree AVB, LAFB, supraventricular ectopic beats, third-degree AVB, ventricular ectopic beats and atrial fibrillation or flutter. For the presence of a single electrocardiographic alterations, the discriminative capacity variables showed: sensitivity 0.511 (0.505, 0.517), specificity 0.622 (0.620, 0.624), Positive Predictive Value (PPV) 0.101 (0.099, 0.103), Negative Predictive Value (NPV) 0.939 (0.937, 0.940), Positive Likelihood Ratio (PLR) 1.352 (1.334, 1.370) and Negative Likelihood Ratio (NLR) 0.786 (0.776, 0.797).

Conclusion

Our findings show a significant association between CD and several electrocardiographic abnormalities, which highlights the need for ongoing surveillance and targeted therapeutic interventions to improve clinical outcomes for patients with chagasic cardiomyopathy.

查看原文本刊更多论文

与普通人群相比，chagasic患者的心电图异常：一项最新荟萃分析的系统综述

恰加斯病仍然是一个严重的公共卫生问题。它可以从急性期发展到慢性期，表现为心肌病，伴有一些典型的心电图异常。目的：本系统综述结合荟萃分析，旨在评估CD患者心律失常的总体患病率，以及对特定心律失常的临床和流行病学变量的鉴别价值。方法在MEDLINE/PubMed、Embase和Cochrane图书馆中检索包括CD患者与其他组相比心电图异常患病率的文章。结果共纳入88项研究的322.608名受试者。单一心电图变化的荟萃分析显示，与非chagasic个体相比，CD血清学阳性具有显著相关性(OR: 2.86 95% CI 2.53；3.23;i2 = 85%)。完全右束支传导阻滞[CRBBB]、CRBBB +左前束传导阻滞[LAFB]、一级房室传导阻滞[AVB]、不完全右束支传导阻滞[IRBBB]、二度AVB、LAFB、室上异位搏、三度AVB、室性异位搏与心房颤动或扑动存在显著相关性。对于单一心电图改变，判别能力变量为：敏感性0.511(0.505,0.517)，特异性0.622(0.620,0.624)，阳性预测值（PPV） 0.101(0.099, 0.103)，阴性预测值（NPV） 0.939(0.937, 0.940)，阳性似然比（PLR） 1.352(1.334, 1.370)，阴性似然比（NLR） 0.786（0.776, 0.797）。结论：我们的研究结果显示CD与几种心电图异常之间存在显著关联，这突出了持续监测和有针对性的治疗干预的必要性，以改善恰加斯型心肌病患者的临床结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of electrocardiology 医学-心血管系统

CiteScore

2.70

自引率

7.70%

发文量

152

审稿时长

38 days

期刊介绍： The Journal of Electrocardiology is devoted exclusively to clinical and experimental studies of the electrical activities of the heart. It seeks to contribute significantly to the accuracy of diagnosis and prognosis and the effective treatment, prevention, or delay of heart disease. Editorial contents include electrocardiography, vectorcardiography, arrhythmias, membrane action potential, cardiac pacing, monitoring defibrillation, instrumentation, drug effects, and computer applications.