查加斯心肌病患者的急性心力衰竭:I巴西心力衰竭登记(呼吸)的结果。

IF 1.9
Pedro Gabriel Melo de Barros E Silva, Denilson Campos Albuquerque, Renato Delascio Lopes, Paulo Roberto Nogueira, Aguinaldo F Freitas, Carlos Vieira Nascimento, Charles Mady, Elizabete Silva Dos Santos, Mauro Esteves Hernandes, Maria Alayde Mendonça Rivera, João David de Souza Neto, Alvaro Rabelo, Manoel Fernandes Canesin, Helder Reis, Anderson da Costa Armstrong, Conrado Hoffmann, Renato Hideo Nakagawa Santos, Isabella de Andrade Jesuino, Luis Eduardo Rohde, Lidia Zytinsky Moura, Fabiana Goulart Marcondes-Braga, Evandro Tinoco Mesquita, José Albuquerque de Figueiredo Neto, Ricardo Mourilhe-Rocha, Luís Beck-da-Silva, Mucio Tavares Oliveira Junior, Marcus Vinicius Simões
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引用次数: 0

摘要

背景:虽然慢性恰加斯心肌病(Chagas' cardiomyopathy, CCC)的临床特征已经确立,但有关患者的临床资料很少。目的:目前的分析报告了I巴西心力衰竭登记处(BREATHE)的结果,评估了由CCC引起的急性心力衰竭患者的基线特征和临床结果。方法:BREATHE共纳入3013例急性心力衰竭住院的成年患者。我们比较分析了261例(8.7%)慢性CCC患者和2752例(91.3%)其他病因的患者。对两组患者的临床和人口统计信息、超声心动图上的心脏结构/功能数据以及住院期间和出院后的预后进行评估。进行了单因素和多变量检验,p值结果:CCC患者的收缩压较低(108.3±26.1 vs 128.3±30.3 mmHg)。结论:与其他病因相比,因急性心力衰竭住院的CCC患者在住院期间和出院后的预后较差,风险较高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Acute Heart Failure in Patients with Chagas Cardiomyopathy: Results of the I Brazilian Heart Failure Registry (BREATHE).

Background: Although the clinical features of chronic Chagas' cardiomyopathy (CCC) have been well established, clinical data about the patients are scarce.

Objectives: The current analysis reports the results of the I Brazilian Heart Failure Registry (BREATHE) assessing baseline characteristics and clinical outcomes of patients with acute heart failure due to CCC.

Methods: BREATHE enrolled a total of 3,013 adult patients hospitalized with acute heart failure. We analyzed comparatively 261 (8.7%) patients with chronic CCC and 2,752 (91.3%) patients with other etiologies. Clinical and demographic information, cardiac structure/function data on echocardiogram and outcomes during the hospital stay and after discharge were assessed in both groups. Uni and multivariate tests were performed and a p-value <0.05 was considered statistically significant.

Results: Patients with CCC presented lower systolic blood pressure (108.3 ± 26.1 vs 128.3 ± 30.3 mmHg, p<0.001) and left ventricle ejection fraction (25.4 [19 - 36]% vs 37 [27 - 54] %, p<0.001) with higher rates of jugular vein distension (54.8% vs 38.9%, p<0.001), hepatomegaly (47.9% vs 25.6%, p<0.001), and "cold and wet" clinical hemodynamic profile (27.2% vs 10.6%, p<0.001). Patients with CCC presented higher rate of the composite death or heart transplantation (17.4% vs. 11.1%, p=0.004), and higher cumulative incidence of death after 3 months (16.5% vs 10.8%, p=0.017), 6 months (25.3% vs 17.2%, p=0.006), and 12 months (39.4% vs 26.6%, p<0.001). Besides, CCC was independently associated with 12-month mortality risk with odds ratio = 2.02 (95% IC: 1.47-2.77).

Conclusion: Patients with CCC, hospitalized due to acute heart failure, in comparison to other etiologies, presented a higher risk profile that was associated with a poorer outcome during hospital stay and after discharge.

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