Bocchi Edimar Alcides
Heart Institute, São Paulo University Medical School, Brazil.
Curr Cardiol Rev. 2013 May;9(2):147-56. doi: 10.2174/1573403x11309020007.
Continued assessment of temporal trends in mortality and epidemiology of specific heart failure in South America is needed to provide a scientific basis for rational allocation of the limited health care resources, and strategies to reduce risk and predict the future burden of heart failure. The epidemiology of heart failure in South America was reviewed. Heart failure is the main cause of hospitalization based on available data from approximately 50% of the South American population. The main etiologies of heart failure are ischemic, idiopathic dilated cardiomyopathy, valvular, hypertensive and chagasic etiologies. In endemic areas, Chagas heart disease may be responsible by 41% of the HF cases. Also, heart failure presents high mortality especially in patients with Chagas etiology. Heart failure and etiologies associated with heart failure may be responsible for 6.3% of causes of deaths. Rheumatic fever is the leading cause of valvular heart disease. However, a tendency to reduction of HF mortality due to Chagas heart disease from 1985 to 2006, and reduction in mortality due to HF from 1999 to 2005 were observed in selected states in Brazil. The findings have important public health implications because the allocation of health care resources, and strategies to reduce risk of heart failure should also consider the control of neglected Chagas disease and rheumatic fever in South American countries.
需要持续评估南美洲特定心力衰竭的死亡率和流行病学的时间趋势，以便为合理分配有限的医疗资源提供科学依据，并制定降低风险和预测未来心力衰竭负担的策略。本文对南美洲心力衰竭的流行病学进行了综述。根据来自约50%南美洲人口的现有数据，心力衰竭是住院的主要原因。心力衰竭的主要病因包括缺血性、特发性扩张型心肌病、瓣膜性、高血压性和恰加斯病因。在流行地区，恰加斯心脏病可能导致41%的心力衰竭病例。此外，心力衰竭的死亡率很高，尤其是由恰加斯病因引起的患者。心力衰竭及与心力衰竭相关的病因可能占死亡原因的6.3%。风湿热是瓣膜性心脏病的主要原因。然而，在巴西的一些选定州，观察到1985年至2006年期间恰加斯心脏病导致的心力衰竭死亡率呈下降趋势，以及1999年至2005年期间心力衰竭死亡率的下降。这些发现具有重要的公共卫生意义，因为医疗资源的分配以及降低心力衰竭风险的策略也应考虑到南美洲国家对被忽视的恰加斯病和风湿热的控制。
