Prognostic value of QT interval parameters for mortality risk stratification in Chagas disease: result of a long-term follow-up study
Autor(a) principal: | |
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Data de Publicação: | 2003 |
Outros Autores: | , , , |
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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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 |
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eng |
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eng |
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info:eu-repo/semantics/openAccess |
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openAccess |
dc.publisher.none.fl_str_mv |
American Heart Association |
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American Heart Association |
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reponame:Repositório Institucional da FIOCRUZ (ARCA) instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
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