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Prognostic Value of Exercise‐Induced Ventricular Arrhythmia in Chagas’ Heart Disease
Author(s) -
PEDROSA ROBERTO COURY,
SALLES JOSÉ HUGO GAMEIRO,
MAGNANINI MONICA M. F.,
BEZERRA DANIEL C.,
BLOCH KATIA VERGETTI
Publication year - 2011
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2011.03171.x
Subject(s) - medicine , hazard ratio , proportional hazards model , cardiology , prospective cohort study , cohort , population , confidence interval , environmental health
Objective: To determine the prevalence and the prognostic value of exercise‐induced ventricular arrhythmia (EIVA) in chronic Chagas’ heart disease.Study Design and Setting: An open prospective cohort of 130 clinically stable patients at a University Hospital outpatient unit in Rio de Janeiro, Brazil, was followed up at scheduled clinical visits from 1990 through 2007. The endpoint was total cardiovascular mortality. Survival curves (Kaplan‐Meier) and a multivariate Cox proportional hazard model were adjusted to determine the association between EIVA and mortality.Results: The median duration of follow‐up was 9.9 years (range, 132 days to 17 years). EIVA prevalence was 43.1% (95% CI: 34.5–51.7) . Thirty‐three cardiovascular deaths (25.4%) occurred. The hazard ratio of EIVA for cardiovascular death, after adjustment for age, was 1.84 (P = 0.09). An interaction was found between EIVA and cardiomegaly on x‐ray. In the group with cardiomegaly, the hazard of dying was four times greater in the presence of EIVA (P for interaction = 0.05).Conclusion: In clinically stable chagasic subjects with cardiomegaly, EIVA is a clinically significant marker of total cardiovascular mortality and may be a useful risk stratification tool in this population. (PACE 2011; 34:1492–1497)