Prognostic value of QT interval parameters for mortality risk stratification in Chagas disease: result of a long-term follow-up study

Detalhes bibliográficos
Autor(a) principal: Salles, G.
Data de Publicação: 2003
Outros Autores: Xavier, S., Souza, A., Hasslocher-Moreno, Alejandro Marcel, Cardoso, C.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/33517
Resumo: 2020-06-17
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spelling Salles, G.Xavier, S.Souza, A.Hasslocher-Moreno, Alejandro MarcelCardoso, C.2019-06-17T12:41:37Z2019-06-17T12:41:37Z2003SALLES, G. et al. Prognostic value of QT interval parameters for mortality risk stratification in Chagas disease: result of a long-term follow-up study. Circulation, v. 108, n. 3, p. 305-312, 2003.0009-7322https://www.arca.fiocruz.br/handle/icict/3351710.1161/01.CIR.0000079174.13444.9C1524-4539engAmerican Heart AssociationPrognostic value of QT interval parameters for mortality risk stratification in Chagas disease: result of a long-term follow-up studyinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article2020-06-17Federal University of Rio de Janeiro. Clementino Fraga Filho University Hospital. Department of Internal Medicine. Rio de Janeiro, RJ, Brazil.Federal University of Rio de Janeiro. Clementino Fraga Filho University Hospital. Department of Internal Medicine. Rio de Janeiro, RJ, Brazil / Fundação Oswaldo Cruz. Hospital Evandro Chagas. Rio de Janeiro, RJ, Brasil.Federal University of Rio de Janeiro. Clementino Fraga Filho University Hospital. Department of Internal Medicine. Rio de Janeiro, RJ, Brazil / Fundação Oswaldo Cruz. Hospital Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Hospital Evandro Chagas. Rio de Janeiro, RJ, Brasil.Federal University of Rio de Janeiro. Clementino Fraga Filho University Hospital. Department of Internal Medicine. Rio de Janeiro, RJ, Brazil.Background: QT interval parameters are potential prognostic markers of arrhythmogenicity risk and cardiovascular mortality and have never been evaluated in Chagas’ disease. Methods and Results: Outpatients (738) in the chronic phase of Chagas’ disease were enrolled in a long-term follow-up study. Maximal heart rate– corrected QT (QTc) and T-wave peak-to-end (TpTe) intervals and QRS, QT, JT, QTapex, and TpTe dispersions and variation coefficients were measured manually and calculated from 12-lead ECGs obtained on admission. Clinical, radiological, and 2-dimensional echocardiographic data were also recorded. Primary end points were all-cause, Chagas’ disease–related, and sudden cardiac mortalities. During a follow-up of 58 39 months, 62 patients died, 54 of Chagas’ disease–related causes and 40 suddenly. Multivariate Cox survival analysis revealed that the QT-interval dispersion (QTd) (hazard ratio, 1.45; 95% confidence interval, 1.29 to 1.63; P0.001, for 10-ms increments) and left ventricular (LV) end-systolic dimension (hazard ratio, 1.36; 95% confidence interval, 1.21 to 1.53; P0.001, for 5-mm increments) were the strongest independent predictors for all end points. The maximum QTc interval (QTcmax) could substitute for QTd with a worse predictive performance. Other predictors were heart rate, presence of pathological Q waves, frequent premature ventricular contractions (PVCs), and isolated left anterior fascicular block (LAFB) on the ECGs. Kaplan-Meier survival curves demonstrated that a QTd 65 ms or a QTcmax 465 ms1/2 discriminated the 2 groups with significantly different prognoses. Conclusions: Electrocardiographic QTd and echocardiographic LV end-systolic dimension were the most important mortality predictors in patients with Chagas’ disease. Heart rate, the presence on ECG of pathological Q waves, frequent PVCs, and isolated LAFB refined the mortality risk stratification.CardiomyopathyMortalitySudden deathElectrocardiographyEchocardiographyinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txttext/plain1748https://www.arca.fiocruz.br/bitstream/icict/33517/1/license.txt8a4605be74aa9ea9d79846c1fba20a33MD51ORIGINALve_Salles_Gil_etal_INI_2003.pdfve_Salles_Gil_etal_INI_2003.pdfapplication/pdf124644https://www.arca.fiocruz.br/bitstream/icict/33517/2/ve_Salles_Gil_etal_INI_2003.pdf37e8e3b6494684ca10eaab2395cbe407MD52TEXTve_Salles_Gil_etal_INI_2003.pdf.txtve_Salles_Gil_etal_INI_2003.pdf.txtExtracted texttext/plain34730https://www.arca.fiocruz.br/bitstream/icict/33517/3/ve_Salles_Gil_etal_INI_2003.pdf.txta86c33d75acd621e12a4528068765ae9MD53icict/335172023-03-08 09:52:45.732oai:www.arca.fiocruz.br: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Repositório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352023-03-08T12:52:45Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)false
dc.title.pt_BR.fl_str_mv Prognostic value of QT interval parameters for mortality risk stratification in Chagas disease: result of a long-term follow-up study
title Prognostic value of QT interval parameters for mortality risk stratification in Chagas disease: result of a long-term follow-up study
spellingShingle Prognostic value of QT interval parameters for mortality risk stratification in Chagas disease: result of a long-term follow-up study
Salles, G.
Cardiomyopathy
Mortality
Sudden death
Electrocardiography
Echocardiography
title_short Prognostic value of QT interval parameters for mortality risk stratification in Chagas disease: result of a long-term follow-up study
title_full Prognostic value of QT interval parameters for mortality risk stratification in Chagas disease: result of a long-term follow-up study
title_fullStr Prognostic value of QT interval parameters for mortality risk stratification in Chagas disease: result of a long-term follow-up study
title_full_unstemmed Prognostic value of QT interval parameters for mortality risk stratification in Chagas disease: result of a long-term follow-up study
title_sort Prognostic value of QT interval parameters for mortality risk stratification in Chagas disease: result of a long-term follow-up study
author Salles, G.
author_facet Salles, G.
Xavier, S.
Souza, A.
Hasslocher-Moreno, Alejandro Marcel
Cardoso, C.
author_role author
author2 Xavier, S.
Souza, A.
Hasslocher-Moreno, Alejandro Marcel
Cardoso, C.
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Salles, G.
Xavier, S.
Souza, A.
Hasslocher-Moreno, Alejandro Marcel
Cardoso, C.
dc.subject.en.pt_BR.fl_str_mv Cardiomyopathy
Mortality
Sudden death
Electrocardiography
Echocardiography
topic Cardiomyopathy
Mortality
Sudden death
Electrocardiography
Echocardiography
description 2020-06-17
publishDate 2003
dc.date.issued.fl_str_mv 2003
dc.date.accessioned.fl_str_mv 2019-06-17T12:41:37Z
dc.date.available.fl_str_mv 2019-06-17T12:41:37Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv SALLES, G. et al. Prognostic value of QT interval parameters for mortality risk stratification in Chagas disease: result of a long-term follow-up study. Circulation, v. 108, n. 3, p. 305-312, 2003.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/33517
dc.identifier.issn.pt_BR.fl_str_mv 0009-7322
dc.identifier.doi.none.fl_str_mv 10.1161/01.CIR.0000079174.13444.9C
dc.identifier.eissn.none.fl_str_mv 1524-4539
identifier_str_mv SALLES, G. et al. Prognostic value of QT interval parameters for mortality risk stratification in Chagas disease: result of a long-term follow-up study. Circulation, v. 108, n. 3, p. 305-312, 2003.
0009-7322
10.1161/01.CIR.0000079174.13444.9C
1524-4539
url https://www.arca.fiocruz.br/handle/icict/33517
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv American Heart Association
publisher.none.fl_str_mv American Heart Association
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
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reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
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