Anormalidades eletrocardiográficas típicas e NT-proBNP elevado na Doença de Chagas

Chagas cardiomyopathy is the most harmful complication of Chagas disease. The electrocardiogram is a well-studied exam and has been considered an important tool for detection and evaluation of Chagas cardiomyopathy since the first years of its description. Many of its abnormalities have been describ...

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Detalles Bibliográficos
Autor: Bruno Oliveira de Figueiredo Brito
Tipo de recurso: tesis de maestría
Estado:Versión publicada
Fecha de publicación:2018
País:Brasil
Institución:Universidade Federal de Minas Gerais (UFMG)
Repositorio:Repositório Institucional da UFMG
Idioma:portugués
OAI Identifier:oai:repositorio.ufmg.br:1843/BUOS-B95GYY
Acceso en línea:http://hdl.handle.net/1843/BUOS-B95GYY
Access Level:acceso abierto
Palabra clave:Peptídeo Natriurético Cerebral
Cardiopatia Chagásica
Eletrocardiograma
Peptídeo Natriurético Encefálico
Estudos Transversais
Cardiomiopatia Chagásica
Eletrocardiografia
Medicina
Descripción
Sumario:Chagas cardiomyopathy is the most harmful complication of Chagas disease. The electrocardiogram is a well-studied exam and has been considered an important tool for detection and evaluation of Chagas cardiomyopathy since the first years of its description. Many of its abnormalities have been described as associated with a worse prognosis. Serum BNP levels were described as inversely related to the left ventricular ejection fraction and as an independent predictor of death. It was not reported how electrocardiographic alterations correlate to NT-proBNP and its analog. The present study aims to describe the baseline electrocardiograms of a large cohort of patients with Chagas disease from endemic area and to establish an association between the number of electrocardiogram alterations and high levels of NT-ProBNP in Chagas disease patients. This study selected 1959 Chagas disease patients in 21 municipalities within a limited region in the northern part of the State of Minas Gerais (Brazil), 1084 of them had Chagas cardiomyopathy. NT-proBNP levels were suggestive of heart failure in 11.7% of this population. One or more electrocardiographic alterations have an Odds Ratio of 9.12 (CI 95% 5.6214.80) to have NT-proBNP elevation. Considering the association between the number of 1, 2, and 3 or more alterations in electrocardiogram and NT-proBNP elevation, the ORs were 7.11 (CI 95% 4.3311.67); 16.04 (CI 95% 9.2727.77) and 47.82 (CI 95% 17.98127.20), respectively. The presence and the number of typical electrocardiographic alterations of Chagas disease are independently associated with the severity of the cardiomyopathy.