Prata S P, da Cunha D F, da Cunha S F, Prata S C, Nogueira N
Faculdade de Medicina do Triângulo Mineiro, Depto Clínica Médica, Uberaba, MG.
Arq Bras Cardiol. 1993 Jun;60(6):369-72.
To assess the prevalence of main electrocardiographic alterations in chagasic patients at University of Triângulo Mineiro Medical School, and compare such alterations between aged and non-aged patients.
Electrocardiograms (ECG) of 2,000 chagasic patients were interpreted. Age, color, sex and concomitant systemic hypertension, congestive heart failure (CHF) and megaesophagus and/or megacolon were registered. Chi-square test was employed to compare aged (60 years or more; n = 378) and non-aged (age less than 60 years; n = 1622) chagasics.
ECG were normal in 9.6% of the patients. The main alterations were: ventricular premature complexes (VPC) 42.2%, left ventricular enlargement (LVE) 38.8%, right bundle branch block (RBBB) 32.4%, left anterior hemiblock 29.2% and ventricular repolarization changes 28.2%. The aged group exhibited greater (p < 0.05) proportion of male patients (1.7:1 vs 1.1:1), white than non-white (3.6:1 vs 2.2:1) and larger percentages (p < 0.01) of systemic hypertension (18.2 vs 7.5) and CHF (26.4 vs 12.0). The following alterations were significantly more common on aged chagasic: VPC (62.7 vs 37.5), LVE (43.4 vs 37.1), atrial fibrillation (19.6 vs 5.5), supraventricular premature complexes (11.9 vs 5.2), electrically inactive zone (9.5 vs 6.6), wandering atrial pacemaker (4.5 vs 2.2) and 2nd-degree atrioventricular (AV) block (2.9 vs 1.5). The non-aged chagasic had greater percentage (p < 0.05) than aged group of normal ECG (10.7 vs 5.0), RBBB (34.1 vs 24.9) and 1st degree AV block (9.7 vs 6.3).
There was a high prevalence of ECG alterations in chagasic patients seeking medical attention. The different frequencies of those alterations between aged and non-aged chagasic may result of conditions more frequently seen in aged, like ischemic heart disease, CHF and systemic hypertension or to a probable more severe cardiac denervation in non-aged chagasic.
评估米纳斯吉拉斯三角大学医学院恰加斯病患者主要心电图改变的患病率，并比较老年和非老年患者之间的此类改变。
对2000例恰加斯病患者的心电图（ECG）进行解读。记录年龄、肤色、性别以及合并的系统性高血压、充血性心力衰竭（CHF）和巨食管和/或巨结肠情况。采用卡方检验比较老年（60岁及以上；n = 378）和非老年（年龄小于60岁；n = 1622）恰加斯病患者。
9.6%的患者心电图正常。主要改变为：室性早搏（VPC）42.2%、左心室扩大（LVE）38.8%、右束支传导阻滞（RBBB）32.4%、左前分支阻滞29.2%和心室复极改变28.2%。老年组男性患者比例更高（p < 0.05）（1.7:1比1.1:1），白人比非白人更多（3.6:1比2.2:1），系统性高血压（18.2%比7.5%）和CHF（26.4%比12.0%）的百分比更高（p < 0.01）。以下改变在老年恰加斯病患者中明显更常见：VPC（62.7%比37.5%）、LVE（43.4%比37.1%）、心房颤动（19.6%比5.5%）、室上性早搏（11.9%比5.2%）、电静止区（9.5%比6.6%）、游走性心房起搏点（4.5%比2.2%）和二度房室（AV）阻滞（2.9%比1.5%）。非老年恰加斯病患者心电图正常（10.7%比5.0%）、RBBB（34.1%比24.9%）和一度AV阻滞（9.7%比6.3%）的百分比高于老年组（p < 0.05）。
寻求医疗关注的恰加斯病患者心电图改变的患病率很高。老年和非老年恰加斯病患者这些改变的不同频率可能是由于老年患者中更常见的疾病，如缺血性心脏病、CHF和系统性高血压，或者可能是非老年恰加斯病患者心脏去神经支配更严重所致。
