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探讨心电图在恰加斯病研究中的历史背景和临床意义。

Exploring the Historical Background and Clinical Implications of Electrocardiogram in the Context of Chagas Disease Research.

机构信息

Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.

Cardion - Cardiologia Preventiva e Avançada, Uberlândia, MG, Brasil.

出版信息

Rev Soc Bras Med Trop. 2023 Dec 15;56:0506. doi: 10.1590/0037-8682-0506-2023. eCollection 2023.

Abstract

Chagas disease (CD) remains one of the most significant endemic diseases in Latin America. Approximately 30% of individuals with CD develop the cardiac form, the main determinant of morbidity and mortality, which is characterized by typical electrocardiogram (ECG) changes caused by chronic chagasic cardiopathy (CCC). This review accentuates to how crucial it is for research teams and reference centers that treat patients with CD to standardize ECG in CCC. This was a non-systematic review of the literature. ECG is the most widely used examination in the diagnosis and evaluation of CCC, and it is also employed in epidemiological surveys, risk stratification for cardiovascular events and death, and monitoring the clinical progression of the disease. Carlos Chagas and Eurico Villela published the first work addressing CCC in 1922. Other works followed, including the study by Evandro Chagas' which was the first to perform ECG in CD, culminating in Francisco Laranja's seminal work in 1956. Since the 1980s, standardizations and ECG reading codes for CD have been established. This standardization aimed to code complex arrhythmias and characteristic ventricular conduction disorders and standardize ECG readings for clinical and epidemiological studies in CD. Nearly all existing electrocardiographic abnormalities can be found in CD, with a predominance of abnormalities in the formation and conduction of cardiac stimuli. The complex and heterogeneous substrate of CD with varied electrocardiographic manifestations poses a significant challenge when comparing studies involving patients with CCC, emphasizing the need for ECG standardization in CD.

摘要

恰加斯病(CD)仍然是拉丁美洲最重要的地方性疾病之一。大约 30%的 CD 患者会发展为心脏形式,这是发病率和死亡率的主要决定因素,其特征是由慢性恰加斯心脏病(CCC)引起的典型心电图(ECG)变化。这篇综述强调了研究团队和治疗 CD 患者的参考中心标准化 CCC 中的 ECG 是多么重要。这是对文献的非系统性综述。ECG 是诊断和评估 CCC 最广泛使用的检查方法,也用于流行病学调查、心血管事件和死亡风险分层以及监测疾病的临床进展。卡洛斯·查加斯和欧里科·维莱拉于 1922 年发表了第一篇关于 CCC 的论文。随后又有其他论文发表,包括埃万德罗·查加斯的研究,这是第一篇在 CD 中进行 ECG 的研究,最终弗朗西斯科·拉兰贾于 1956 年发表了开创性的工作。自 20 世纪 80 年代以来,已经为 CD 建立了标准化和 ECG 阅读代码。这种标准化旨在对复杂的心律失常和特征性心室传导障碍进行编码,并为 CD 的临床和流行病学研究标准化 ECG 读数。几乎所有现有的心电图异常都可以在 CD 中发现,以心脏刺激的形成和传导异常为主。CD 的复杂和异质基质与各种心电图表现,在比较涉及 CCC 患者的研究时带来了重大挑战,强调了 CD 中 ECG 标准化的必要性。

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