PMID- 29509903
OWN - NLM
STAT- MEDLINE
DCOM- 20190620
LR  - 20190620
IS  - 1532-2092 (Electronic)
IS  - 1099-5129 (Linking)
VI  - 20
IP  - 11
DP  - 2018 Nov 1
TI  - A cohort study of cardiac resynchronization therapy in patients with chronic 
      Chagas cardiomyopathy.
PG  - 1813-1818
LID - 10.1093/europace/eux375 [doi]
AB  - AIMS: Cardiac resynchronization therapy (CRT) is an established procedure for 
      patients with heart failure. However, trials evaluating its efficacy did not 
      include patients with chronic Chagas cardiomyopathy (CCC). We aimed to assess the 
      role of CRT in a cohort of patients with CCC. METHODS AND RESULTS: This 
      retrospective study compared the outcomes of CCC patients who underwent CRT with 
      those of dilated (DCM) and ischaemic cardiomyopathies (ICM). The primary endpoint 
      was all-cause mortality and the secondary endpoints were the rate of non-advanced 
      New York Heart Association (NYHA) class 12 months after CRT and echocardiographic 
      changes evaluated at least 6 months after CRT. There were 115 patients in the CCC 
      group, 177 with DCM, and 134 with ICM. The annual mortality rates were 25.4%, 
      10.4%, and 11.3%, respectively (P < 0.001). Multivariate analysis adjusted for 
      potential confounders showed that the CCC group had a two-fold [hazard ratio 2.34 
      (1.47-3.71), P < 0.001] higher risk of death compared to the DCM group. The rate 
      of non-advanced NYHA class 12 months after CRT was significantly higher in 
      non-CCC groups than in the CCC group (DCM 74.0% vs. ICM 73.9% vs. 56.5%, 
      P < 0.001). Chronic Chagas cardiomyopathy and ICM patients had no improvement in 
      the echocardiographic evaluation, but patients in the DCM group had an increase 
      in left ventricular ejection fraction and a decrease in left ventricular 
      end-diastolic diameter. CONCLUSION: This study showed that CCC patients submitted 
      to CRT have worse prognosis compared to patients with DCM and ICM who undergo 
      CRT. Studies comparing CCC patients with and without CRT are warranted.
FAU - Martinelli Filho, Martino
AU  - Martinelli Filho M
AD  - Heart Institute (InCor), University of Sao Paulo Medical School, Av. Eneas de 
      Carvalho Aguiar, Sao Paulo, SP, Brazil.
FAU - de Lima Peixoto, Giselle
AU  - de Lima Peixoto G
AD  - Heart Institute (InCor), University of Sao Paulo Medical School, Av. Eneas de 
      Carvalho Aguiar, Sao Paulo, SP, Brazil.
FAU - de Siqueira, Sergio Freitas
AU  - de Siqueira SF
AD  - Heart Institute (InCor), University of Sao Paulo Medical School, Av. Eneas de 
      Carvalho Aguiar, Sao Paulo, SP, Brazil.
FAU - Martins, Sergio Augusto Mezzalira
AU  - Martins SAM
AD  - Heart Institute (InCor), University of Sao Paulo Medical School, Av. Eneas de 
      Carvalho Aguiar, Sao Paulo, SP, Brazil.
FAU - Nishioka, Silvana Angelina D'orio
AU  - Nishioka SAD
AD  - Heart Institute (InCor), University of Sao Paulo Medical School, Av. Eneas de 
      Carvalho Aguiar, Sao Paulo, SP, Brazil.
FAU - Pedrosa, Anisio Alexandre Andrade
AU  - Pedrosa AAA
AD  - Heart Institute (InCor), University of Sao Paulo Medical School, Av. Eneas de 
      Carvalho Aguiar, Sao Paulo, SP, Brazil.
FAU - Teixeira, Ricardo Alkmim
AU  - Teixeira RA
AD  - Heart Institute (InCor), University of Sao Paulo Medical School, Av. Eneas de 
      Carvalho Aguiar, Sao Paulo, SP, Brazil.
FAU - Dos Santos, Johnny Xavier
AU  - Dos Santos JX
AD  - Heart Institute (InCor), University of Sao Paulo Medical School, Av. Eneas de 
      Carvalho Aguiar, Sao Paulo, SP, Brazil.
FAU - Costa, Roberto
AU  - Costa R
AD  - Heart Institute (InCor), University of Sao Paulo Medical School, Av. Eneas de 
      Carvalho Aguiar, Sao Paulo, SP, Brazil.
FAU - Kalil Filho, Roberto
AU  - Kalil Filho R
AD  - Heart Institute (InCor), University of Sao Paulo Medical School, Av. Eneas de 
      Carvalho Aguiar, Sao Paulo, SP, Brazil.
FAU - Ramires, Jose Antonio Franchini
AU  - Ramires JAF
AD  - Heart Institute (InCor), University of Sao Paulo Medical School, Av. Eneas de 
      Carvalho Aguiar, Sao Paulo, SP, Brazil.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Europace
JT  - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal 
      of the working groups on cardiac pacing, arrhythmias, and cardiac cellular 
      electrophysiology of the European Society of Cardiology
JID - 100883649
SB  - IM
CIN - Europace. 2018 Nov 1;20(11):1717-1718. PMID: 29509893
MH  - Brazil/epidemiology
MH  - *Cardiac Resynchronization Therapy/adverse effects/methods
MH  - Cardiomyopathy, Dilated/diagnosis/mortality/physiopathology/therapy
MH  - *Chagas Cardiomyopathy/diagnosis/mortality/physiopathology/therapy
MH  - Defibrillators, Implantable
MH  - Echocardiography/methods
MH  - Female
MH  - Heart Failure/etiology/mortality/therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Stroke Volume
EDAT- 2018/03/07 06:00
MHDA- 2019/06/21 06:00
CRDT- 2018/03/07 06:00
PHST- 2017/09/18 00:00 [received]
PHST- 2017/12/20 00:00 [accepted]
PHST- 2018/03/07 06:00 [pubmed]
PHST- 2019/06/21 06:00 [medline]
PHST- 2018/03/07 06:00 [entrez]
AID - 4917642 [pii]
AID - 10.1093/europace/eux375 [doi]
PST - ppublish
SO  - Europace. 2018 Nov 1;20(11):1813-1818. doi: 10.1093/europace/eux375.