Apt W, Arribada A, Cabrera L, Sandoval J
J Trop Med Hyg. 1983 Dec;86(6):217-22.
As part of study of Chagasic cardiopathy in Chile we report a follow-up study of 100 cardiopathic patients from two endemic areas who had been diagnosed 4 years earlier during an epidemiological and clinical survey. The follow-up consisted of a clinical, serological and electrocardiographic examination, and a continuous ECG recording for 60 min to detect possible arrhythmias. From the original 100 cases, three had died: one of a gastric cancer and the other two due to probable chagasic cardiopathy. Twenty-six had migrated to other areas and were lost to our study. From the remaining 71 patients, 48 were asymptomatic and 23 had complaints including palpitations, dyspnoea and Stokes-Adams crisis. In most cases, seropositivity by indirect haemagglutination did not change, but in six cases the titres decreased, becoming negative in three of them. Xeno-diagnosis was positive in 19.3% of seropositive patients. The ECG had returned to normal in 18 cases (17%) but showed a higher degree of blockades in others, three of which reached complete A-V block. The 60 min ECG was very important as it showed alterations in 93% of the cases, revealing arrhythmias that the ECG alone did not show. This work demonstrates that chagasic cardiopathy in Chile is a slow, progressive disease, that attacks the heart as a whole, but with special damage to the conducting tissues.
作为智利恰加斯病性心脏病研究的一部分，我们报告了一项对100名心脏病患者的随访研究，这些患者来自两个流行地区，4年前在一次流行病学和临床调查中被诊断出患病。随访包括临床、血清学和心电图检查，以及连续60分钟的心电图记录以检测可能的心律失常。在最初的100例病例中，3例死亡：1例死于胃癌，另外2例可能死于恰加斯病性心脏病。26例已迁移到其他地区，我们无法继续对其进行研究。在其余71名患者中，48例无症状，23例有包括心悸、呼吸困难和斯托克斯 - 亚当斯发作等症状。在大多数情况下，间接血凝试验的血清阳性结果没有变化，但在6例中滴度下降，其中3例变为阴性。在19.3%的血清阳性患者中，异种诊断呈阳性。18例（17%）患者的心电图已恢复正常，但其他患者显示出更高程度的传导阻滞，其中3例达到完全房室传导阻滞。60分钟的心电图非常重要，因为它显示93%的病例有改变，揭示了单独心电图未显示的心律失常。这项研究表明，智利的恰加斯病性心脏病是一种缓慢进展的疾病，它会侵袭整个心脏，但对传导组织有特别的损害。
