Terzi Flavia Vernin de Oliveira, Siqueira Filho Aristarco Gonçalves de, Nascimento Emília Matos do, Pereira Basílio de Bragança, Pedrosa Roberto Coury
Serviço de Cardiologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ.
Rev Soc Bras Med Trop. 2010 Sep-Oct;43(5):557-61. doi: 10.1590/s0037-86822010000500017.
Sudden death is the major cause of death among chagasic patients. A significant number of fatal events in patients without apparent heart disease and borderline electrocardiogram, but with contractile ventricular dysfunction, have been documented. This work aimed to determine the association between regional dysfunction and the presence of ventricular arrhythmia in chagasic patients without apparent heart disease.
Forty-nine patients with normal or borderline electrocardiogram were submitted to echocardiogram, exercise stress test and Holter. The presence of cardiac contractile alterations and complex ventricular arrhythmia was analyzed. Statistic analysis used the general Log-Linear model.
Mean age 56 years-old; 55% women. Regional ventricular dysfunction was verified in 24.5% of patients; positive Holter in 12% and exercise stress test in 18%. An association between complex ventricular arrhythmia and contractile abnormalities in the presence of mild left ventricle dysfunction was verified.
Regional contractile abnormalities with mild left ventricle dysfunction in Chagasic patients indicate a group with higher risk of complex ventricular arrhythmias, who require specific follow-up.
猝死是恰加斯病患者的主要死因。已有文献记载,在无明显心脏病且心电图临界但存在心室收缩功能障碍的患者中,有相当数量的致命事件。这项研究旨在确定无明显心脏病的恰加斯病患者局部功能障碍与室性心律失常之间的关联。
49例心电图正常或临界的患者接受了超声心动图、运动负荷试验和动态心电图监测。分析心脏收缩改变和复杂性室性心律失常的存在情况。统计分析采用一般对数线性模型。
平均年龄56岁;55%为女性。24.5%的患者存在局部心室功能障碍;12%的动态心电图监测结果为阳性,18%的运动负荷试验结果为阳性。在轻度左心室功能障碍的情况下,证实了复杂性室性心律失常与收缩异常之间存在关联。
恰加斯病患者存在轻度左心室功能障碍的局部收缩异常表明这是一组发生复杂性室性心律失常风险较高的人群,需要进行特定的随访。