Costa Henrique Silveira, Nunes Maria Carmo Pereira, Souza Aline Cristina de, Lima Marcia Maria Oliveira, Carneiro Renata Bicalho, Sousa Giovane Rodrigo de, Rocha Manoel Otávio da Costa
Curso de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Departamento de Fisioterapia, Faculdade de Ciências da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.
Rev Soc Bras Med Trop. 2015 Mar-Apr;48(2):175-80. doi: 10.1590/0037-8682-0295-2014.
Exercise-induced ventricular arrhythmia (EIVA) and autonomic imbalance are considered as early markers of heart disease in Chagas disease (ChD) patients. The objective of the present study was to verify the differences in the occurrence of EIVA and autonomic maneuver indexes between healthy individuals and ChD patients with no apparent cardiac involvement.
A total of 75 ChD patients with no apparent cardiac involvement, aged 44.7 (8.5) years, and 38 healthy individuals, aged 44.0 (9.2) years, were evaluated using echocardiography, symptom-limited treadmill exercise testing and autonomic function tests.
The occurrence of EIVA was higher in the chagasic group (48%) than in the control group (23.7%) during both the effort and the recovery phases. Frequent ventricular contractions occurred only in the patient group. Additionally, the respiratory sinus arrhythmia index was significantly lower in the chagasic individuals compared with the control group.
ChD patients with no apparent cardiac involvement had a higher frequency of EIVA as well as more vagal dysfunction by respiratory sinus arrhythmia. These results suggest that even when asymptomatic, ChD patients possess important arrhythmogenic substrates and subclinical disease.
运动诱发的室性心律失常（EIVA）和自主神经失衡被认为是恰加斯病（ChD）患者心脏病的早期标志物。本研究的目的是验证健康个体与无明显心脏受累的ChD患者在EIVA发生率和自主神经调节指标方面的差异。
对75名无明显心脏受累、年龄为44.7（8.5）岁的ChD患者和38名年龄为44.0（9.2）岁的健康个体进行了超声心动图、症状限制平板运动试验和自主神经功能测试。
在运动期和恢复期，恰加斯病组的EIVA发生率（48%）均高于对照组（23.7%）。频发室性早搏仅出现在患者组。此外，恰加斯病患者的呼吸性窦性心律失常指数显著低于对照组。
无明显心脏受累的ChD患者EIVA发生率更高，且呼吸性窦性心律失常导致的迷走神经功能障碍更明显。这些结果表明，即使无症状，ChD患者也存在重要的致心律失常基质和亚临床疾病。
