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巴西米纳斯吉拉斯州维热姆达帕拉的查加斯病:24 年间的左心室动脉瘤和死亡风险。

Chagas disease in Virgem da Lapa, Minas Gerais, Brazil: left ventricle aneurysm and the risk of death in the 24-year interval.

机构信息

Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Doenças Parasitárias, Rio de Janeiro, RJ, Brasil.

Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.

出版信息

Mem Inst Oswaldo Cruz. 2020 Jun 12;115:e200056. doi: 10.1590/0074-02760200056. eCollection 2020.

Abstract

BACKGROUND

Left ventricular aneurysm (LVA) is indicator of high morbidity in Chagas' disease. A cross-sectional study performed identified LVA in 18.8% of the chronic chagasic patients (CCP).

OBJECTIVE

Determine the risk of death of patients with chronic chagasic cardiopathy (CCC) and LVA in 24-year interval.

MATERIAL AND METHODS

In 1995 a cohort of 298 CCP was evaluated by anamnesis, physical examination, EKG and ECHO and classified in groups: G0 = 86 without cardiopathy; G1 = 156 with cardiopathy without LVA and G2 = 56 with cardiopathy and LVA. 38 patients of G0 and G1 used benznidazole. Information about the deaths was obtained in the notary, death certificates, hospital records and family members.

FINDINGS

Were registered 113 deaths (37.9%): 107 (35.9%) attributed to cardiopathy and 6 (2.0%) to other causes (p < 0.05). Amongst these 107 deaths, 10 (11.6%) occurred in G0; 49 (31.4%) occurred in G1 and 48 (85.7%) occurred in G2 (p < 0.05). The risk of death was 2.7 and 7.4 times significantly higher in G2, than in G1 and G0, respectively.

CONCLUSION

Chronic chagasic patients with LVA and ejection fraction < 45% have a higher risk of death than those without.

摘要

背景

左心室室壁瘤(LVA)是恰加斯病高发病率的指标。一项横断面研究发现,慢性恰加斯病患者(CCP)中有 18.8%存在 LVA。

目的

确定 24 年间隔内患有慢性恰加斯心病(CCC)和 LVA 的患者的死亡风险。

材料和方法

1995 年,对 298 例 CCP 进行了病史、体格检查、心电图和超声心动图评估,并分为以下三组:G0=86 例无心脏病;G1=156 例无 LVA 的心脏病;G2=56 例伴 LVA 的心脏病。G0 和 G1 中有 38 例患者使用苯硝唑。通过公证人、死亡证明、医院记录和家属获得有关死亡的信息。

发现

共登记 113 例死亡(37.9%):107 例(35.9%)归因于心脏病,6 例(2.0%)归因于其他原因(p<0.05)。在这 107 例死亡中,G0 组有 10 例(11.6%);G1 组有 49 例(31.4%);G2 组有 48 例(85.7%)(p<0.05)。与 G1 组和 G0 组相比,G2 组的死亡风险分别显著升高 2.7 倍和 7.4 倍。

结论

LVA 且射血分数<45%的慢性恰加斯病患者的死亡风险高于无 LVA 和射血分数<45%的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cae/7292011/6279be8d5a07/1678-8060-mioc-115-e200056-gf1.jpg

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