Noninvasive predictors of mortality for patients with Chagas' heart disease: a multivariate stepwise logistic regression study

• Published in: Cardiology Vol. 84; no. 4-5; p. 261
• Main Authors: Bestetti, R B, Dalbo, C M, Freitas, O C, Teno, L A, Castilho, O T, Oliveira, J S
• Format: Journal Article
• Language: English
• Published: Switzerland 01.01.1994
• Subjects: Actuarial Analysis; Chagas Cardiomyopathy - drug therapy; Chagas Cardiomyopathy - mortality; Chagas Cardiomyopathy - physiopathology; Female; Hemodynamics; Humans; Logistic Models; Male; Middle Aged; Multivariate Analysis; Prognosis; Prospective Studies; Stroke Volume; Survival Analysis; Survivors
• ISSN: 0008-6312
• DOI: 10.1159/000176409

This prospective investigation was conducted in an attempt to identify noninvasive predictors of mortality for patients with Chagas' heart disease through a multivariate stepwise logistic regression study. Fifty-six patients with a positive complement fixation test for Chagas' disease were followed up at the Cardiomyopathy Clinic of our institution from April 1990 to April 1992. Patient age was 59 +/- 17 years; 28 (50%) were male. Upon admission, 19 patients (33%) were in the New York Heart Association (NYHA) class III and 8 (14%) in the NYHA class IV. Systolic blood pressure was 125 +/- 23 mm Hg, diastolic blood pressure 76 +/- 11 mm Hg and resting heart rate 77 +/- 11 beats/min. Forty patients (71%) were given digitalis and 39 (69%) angiotensin-converting enzyme inhibitors. Plasma Na+ was 140 +/- 4 mEq/l, K+ was 4.34 +/- 0.73 mEq/l and creatinine level 1.34 +/- 0.31 mg/100 ml. Cardiomegaly was observed in the chest X-ray of 41 of 51 (79%) available patients. Atrial fibrillation was observed in the resting ECG of 24 of 54 (44%) available patients, premature ventricular contractions in 23 (41%), right bundle branch block in 26 (46%) and left anterior hemiblock in 26 (46%) patients. Echocardiography revealed a left ventricular ejection fraction of 0.45 +/- 0.16, left ventricular systolic dimension of 51.23 +/- 13.53 mm and left ventricular diastolic dimension of 62.94 +/- 19 mm. Sixteen (28%) patients died during the 2-year study, 11 of them suddenly.