Guerrero et al.1313. Guerrero L, Carrasco H, Parada H, Molina C, Chuecos R. [Ventricular mechanics and cardiac arrhythmias in patients with chagasic and primary dilated cardiomyopathy. Echo-electrocardiographic follow-up]. Arq Bras Cardiol. 1991;56(6):465-9.
|
1991 |
Venezuela |
Cohort |
269 |
> 18 |
Yes |
Yes |
The higher prevalence of complex ventricular arrhythmias in chronic Chagasic patients, compared to those with primary dilated cardiomyopathy, exposes Chagasic patients to a worse prognosis. |
Marin-Neto et al.1414. Marin-Neto JA, Bromberg-Marin G, Pazin-Filho A, Simões MV, Maciel BC. Cardiac autonomic impairment and early myocardial damage involving the right ventricle are independent phenomena in Chagas' disease. Int J Cardiol. 1998;65(3):261-9.
|
1998 |
Brazil |
Prospective |
45 |
With digestive tract abnormalities = 39.4 ± 10.7 |
Yes |
Yes |
Dysautonomia is evident in chagasic patients with the digestive form, but not with the indeterminate form. There is no causal association with early myocardial damage, apparent only in patients with impaired right ventricular function, which appears to be the mechanism for the predominance of systemic over pulmonary congestion when heart failure occurs. |
Without abnormalities = 42.4 ± 11.9 |
Barros et al.1515. Barros MV, Rocha MO, Ribeiro AL, Machado FS. Doppler tissue imaging to evaluate early myocardium damage in patients with undetermined form of Chagas' disease and normal echocardiogram. Echocardiography. 2001;18(2):131-6.
|
2001 |
Brazil |
Prospective |
40 |
Not informed |
Yes |
Yes |
TDI allowed the identification of higher isovolumic contraction of the septal wall in chagasic patients with the indeterminate form. |
Barros et al.1616. Barros MV, Machado FS, Ribeiro AL, Da Costa Rocha MO. Detection of early right ventricular dysfunction in Chagas' disease using Doppler tissue imaging. J Am Soc Echocardiogr. 2002;15(10 Pt 2):1197-201.
|
2002 |
Brazil |
Prospective |
30 |
39.9 ± 9.9 |
Yes |
Yes |
TDI allows early identification of the RV dysfunction (increased isovolumic contraction of the septal and lateral walls). |
Barros et al.1717. Barros MV, Ribeiro AL, Machado FS, Rocha MO. Doppler tissue imaging to assess systolic function in Chagas' disease. Arq Bras Cardiol. 2003;80(1):36-40.
|
2003 |
Brazil |
Prospective cross-sectional |
77 |
Control: 35.8 ± 10.6 |
Yes |
Yes |
Tissue Doppler imaging (TDI) identifies early contractility abnormalities. |
Chagasic com normal ECG: 40.7 ± 8.5 |
Chagasic with abnormal ECG: 43.9 ± 11.1 |
Arias et al.1818. Arias R, Bastos C, Mota G, Sodré F, Moreira A, Tavares A, et al. Troponin in Chagas disease. Braz J Infect Dis. 2003;7(6):358-9.
|
2003 |
Brazil |
Prospective cross-sectional |
60 |
> 18 |
Yes |
Yes |
Troponin levels are elevated in different clinical presentations of Chagas' disease and detect early inflammation. |
Nunes et al.1919. Nunes Mdo C, Barbosa Mde M, Brum VA, Rocha MO. Morphofunctional characteristics of the right ventricle in Chagas' dilated cardiomyopathy. Int J Cardiol. 2004;94(1):79-85.
|
2004 |
Brazil |
Prospective cross-sectional |
74 |
47.5 ± 12.9 (22-73) |
Yes |
No |
RV dysfunction was significantly associated with LV involvement and pulmonary hypertension, which was more correlated with RV overload than to contractility. |
Viotti et al.2020. Viotti RJ, Vigliano C, Laucella S, Lococo B, Petti M, Bertocchi G, et al. Value of echocardiography for diagnosis and prognosis of chronic Chagas disease cardiomyopathy without heart failure. Heart. 2004;90(6):655-60.
|
2004 |
Argentina |
Cohort |
849 |
> 18 |
Yes |
No |
Echocardiography determines the prognosis of chronic Chagasic patients without congestive heart failure (CHF). |
Talvani et al.2121. Talvani A, Rocha MO, Cogan J, Maewal P, de Lemos J, Ribeiro AL, et al. Brain natriuretic peptide and left ventricular dysfunction in chagasic cardiomyopathy. Mem Inst Oswaldo Cruz. 2004;99(6):645-9.
|
2004 |
Brazil |
Prospective cross-sectional |
81 |
43.5 ± 11.1 |
Yes |
Yes |
High levels of brain natriuretic peptide (BNP) in Chagasic patients detect heart failure (HF) or severe HF manifestations, generating arrhythmias. |
Rocha et al.2222. Rocha ES, Nunes MC, Rocha MO, Barbosa MM. Volume de átrio esquerdo como preditor de morte em miocardiopatia chagásica dilatada. Rev Bras Ecocardiogr. 2004;17(4):29-36.
|
2004 |
Brazil |
Cohort |
60 |
47 ± 13 |
Yes |
No |
Left atrial volume (LAV) was an important predictor of death in Chagas disease. |
Freitas et al.2323. Freitas HF, Chizzola PR, Paes AT, Lima AC, Mansur AJ. Risk stratification in a Brazilian hospital-based cohort of 1220 outpatients with heart failure: role of Chagas' heart disease. Int J Cardiol. 2005;102(2):239-47.
|
2005 |
Brazil |
Cohort |
1220 |
13 ± 72 (45) |
Yes |
No |
Chagasic etiology in HF patients was the main prognostic factor for mortality. |
Melo et al.2424. Melo RB, Parente GB, Victor EG. Determinação do peptídio natriurético cerebral humano em portadores de doença de Chagas. Arq Bras Cardiol. 2005;84(2):137-40.
|
2005 |
Brazil |
Transversal |
25 |
62.7 ± 7.7 chronic 42.2 ± 11.7 asymptomatic |
Yes |
Yes (Chagas asymptomatic x symptomatic) |
BNP increases with worsening functional class and cardiac area. |
Pazin-Filho et al.2525. Pazin-Filho A, Romano MM, Almeida-Filho OC, Furuta MS, Viviani LF, Schmidt A, et al. Minor segmental wall motion abnormalities detected in patients with Chagas' disease have adverse prognostic implications. Braz J Med Biol Res. 2006;39(4):483-7.
|
2006 |
Brazil |
Prospective cross-sectional |
59 |
37-76 > 55 |
Yes |
No |
In time, slight alterations in the left ventricular ejection fraction (LVEF) lead to the worsening of global LV systolic function. |
Rassi Jr et al.2626. Rassi A Jr, Rassi A, Little WC, Xavier SS, Rassi SG, Rassi AG, et al. Development and validation of a risk score for predicting death in Chagas' heart disease. N Engl J Med. 2006;355(8):799-808.
|
2006 |
Brazil |
Cohort |
424 |
47 ± 11 |
Yes |
Yes |
Development of death risk assessment in chagasic cardiomyopathy based on six factors |
Chaves et al.2727. Chaves AM, Villar JC, Luengas CA, Villamizar MC, Hernández L, Celis A, et al. Función diastólica en sujetos con serología positiva para enfermedad de Chagas procedentes del estudio CHICAMOCHA. Rev Colomb Cardiol. 2006;13(2):79-84.
|
2006 |
Colombia |
Prospective cross-sectional |
430 |
Md = 40.5 (IQR = 36-45) |
Yes |
Yes |
Comparing controls, stage I and stage II using tissue Doppler, it is possible to identify, in stage II, the greater relaxation time, lower velocity of A wave, higher E/A ratio, lower pulmonary A velocity, greater pulmonary/mitral A velocity ratio, greater annulus A wave velocity, and the RV shows increased tricuspid A wave velocity and isovolumic contraction time. |
Benchimol Barbosa2828. Benchimol Barbosa PR. Noninvasive prognostic markers for cardiac death and ventricular arrhythmia in long-term follow-up of subjects with chronic Chagas' disease. Braz J Med Biol Res. 2007;40(2):167-78.
|
2007 |
Brazil |
Cohort |
50 |
34-74 |
Yes |
No |
In the male gender, pathological Q wave, ventricular extrasystoles, ventricular tachycardia and abnormal echocardiogram (diastolic and systolic dysfunction and apical aneurysm) are markers of poorer prognosis. |
Barbosa et al.2929. Barbosa MM, Nunes Mdo C, Ribeiro AL, Barral MM, Rocha MO. N-terminal proBNP levels in patients with Chagas disease: a marker of systolic and diastolic dysfunction of the left ventricle. Eur J Echocardiogr. 2007;8(3):204-12.
|
2007 |
Brazil |
Prospective cross-sectional |
59 |
48 ± 11 |
Yes |
No |
The pro-BNP levels remained a strong correlation with LVEF and duration indices of diastolic dysfunction of left atrial volume, as well as with the more severe forms of the disease, allowing their differentiation from the moderate forms. |
Nunes et al.3030. Nunes Mdo C, Rocha MO, Ribeiro AL, Colosimo EA, Rezende RA, Carmo GA, et al. Right ventricular dysfunction is an independent predictor of survival in patients with dilated chronic Chagas' cardiomyopathy. Int J Cardiol. 2008;127(3):372-9.
|
2008 |
Brazil |
Cohort |
158 |
48 ± 12 |
Yes |
No |
Evaluation of systolic and diastolic function using the Tei index (myocardial performance index) and CF showed to be useful prognostic tool in Chagasic cardiomyopathy. |
Villas-Boas et al.3131. Vilas-Boas F, Feitosa GS, Soares MB, Pinho-Filho JA, Nascimento T, Barojas MM, et al. Invasive and noninvasive correlations of B-type natriuretic peptide in patients with heart failure due to Chagas cardiomyopathy. Congest Heart Fail. 2008;14(3):121-6.
|
2008 |
Brazil |
Prospective cross-sectional |
38 |
51.3 ± 1.6 for chagasic and 53.3 ± 2.3 for control patients |
Yes |
Yes |
The concentration of BNP is increased and correlates with heart failure (direct), functional class (direct) natremia (reverse), blood pressure (reverse), right atrial pressure, R/L ventricular dysfunction, TNF-alpha (demonstrating inflammatory characteristic of the disease). |
Nunes et al.3232. Nunes MC, Barbosa MM, Ribeiro AL, Colosimo EA, Rocha MO. Left atrial volume provides independent prognostic value in patients with Chagas cardiomyopathy. J Am Soc Echocardiogr. 2009;22(1):82-8.
|
2009 |
Brazil |
Cohort |
192 |
48 ± 12 |
Yes |
No |
LAV provides powerful information to predict mortality regardless of clinical and echocardiographic data. |
Del Castillo et al.3333. Del Castillo JM, Herszkowicz N, Rego LC, Silva YA, Moro DR, Maia AM, et al. Strain bidimensional do ventrículo esquerdo na forma indeterminada da doença de Chagas. Rev Bras Ecocardiogr Imagem Cardiovasc. 2009;22(1):31-5.
|
2009 |
Brazil |
Prospective cross-sectional |
40 |
55 ± 10 |
Yes |
Yes |
Based on the principle of speckle tracking and employing the assessment of intramyocardial velocity gradients, they identified the reduction in the percentage of deformation (X-strain) and the rate of deformation (strain rate) of the infero-lateral left ventricular wall in Chagas patients unidentifiable by clinical data or conventional echocardiography. |
Terzi et al.3434. Terzi FV, Siqueira Filho AG, Nascimento EM, Pereira Bde B, Pedrosa RC. [Regional left ventricular dysfunction and its association with complex ventricular arrhythmia, in chagasic patients with normal or borderline electrocardiogram]. Rev Soc Bras Med Trop. 2010;43(5):557-61.
|
2010 |
Brazil |
Prospective cross-sectional |
62 |
58 |
Yes |
No |
Chagasic patients with normal LVEF and normal electrocardiogram had a significant frequency of contractile alterations related with arrhythmias and reduced LVEF. |
Pereira Nunes et al.3535. Pereira Nunes Mdo C, Barbosa MM, Ribeiro AL, Amorim Fenelon LM, Rocha MO. Factores predictivos de la mortalidad en pacientes con miocardiopatía dilatada: importancia de la enfermedad de Chagas como etiología. Rev Esp Cardiol. 2010;63(7):788-97.
|
2010 |
Brazil |
Cohort |
287 |
Chagasic: 48.3 ± 12 |
Yes |
Yes |
Identification of Chagasic etiology resulted in poor prognosis in patients with HF, regardless of clinical and echocardiography data. |
Idiopathic: 49.6 ± 15.9 |
Nunes et al.3636. Nunes Mdo C, Beloti FR, Lima MM, Barbosa MM, Pinto Filho MM, de Barros MV, et al. Functional capacity and right ventricular function in patients with Chagas heart disease. Eur J Echocardiogr. 2010;11(7):590-5.
|
2010 |
Brazil |
Cohort |
65 |
48.6 ± 9.1 |
Yes |
No |
RV dysfunction is an important determinant, regardless of exercise capacity, and the systolic valvular velocity of this ventricle was associated with the peak volume of O2 consumed, regardless of age, gender and echocardiographic parameters. |
Garcia-Alvarez et al.3737. Garcia-Alvarez A, Sitges M, Pinazo MJ, Regueiro-Cueva A, Posada E, Poyatos S, et al. Chagas cardiomyopathy: the potential of diastolic dysfunction and brain natriuretic peptide in the early identification of cardiac damage. PLoS Negl Trop Dis. 2010;4(9):e826.
|
2010 |
Spain |
Cohort |
54 |
20-58 (mean 37) |
Yes |
Yes (4 groups) |
The identification of diastolic dysfunction can be achieved by increasing BNP, which correlates with functional class (NYHA), TNF-alpha, PS, endothelin, ANP and reduction in the percentage of longitudinal and radial deformation to assess contractility. |
Duarte et al.3838. Duarte Jde O, Magalhães LP, Santana OO, Silva LB, Simões M, Azevedo DO, et al. Prevalence and prognostic value of ventricular dyssynchrony in Chagas cardiomyopathy. Arq Bras Cardiol. 2011;96(4):300-6.
|
2011 |
Brazil |
Cohort |
56 |
56 ± 10 |
Yes |
No |
Although high prevalence of intraventricular dyssynchrony and moderate interventricular dyssynchrony was demonstrated among Chagasic patients, especially in patients without a pacemaker, dyssynchrony did not show to be a risk factor for poor prognosis. |
Valerio et al.3939. Valerio L, Roure S, Sabria M, Balanzo X, Valles X, Seres L. Clinical, electrocardiographic and echocardiographic abnormalities in Latin American migrants with newly diagnosed Chagas disease 2005-2009, Barcelona, Spain. Euro Surveill. 2011;16(38):19971.
|
2011 |
Spain |
Descriptive |
100 |
38.2 ± 10.2 |
Yes |
No |
The fact that Spain has become a center of migration of Latin Americans in Europe has aroused the concern of Chagas disease becoming an important cause of cardiomyopathy in health services. |
Nunes et al.4040. Nunes MP, Colosimo EA, Reis RC, Barbosa MM, Silva JL, Barbosa F, et al. Different prognostic impact of the tissue Doppler-derived E/e' ratio on mortality in Chagas cardiomyopathy patients with heart failure. J Heart Lung Transplant. 2012;31(6):634-41.
|
2012 |
Brazil |
Prospective endpoint |
232 |
48 ± 12 |
Yes |
Yes (survivors and deaths) |
Using tissue Doppler imaging, they identified risk factors for death: functional class III and IV increased RV Tei, increased left atrial volume index and interaction of LV ejection fraction and E / E' index and protectors: E / E ' ratio and reduction in LV ejection fraction. |
Vasconcelos and Junqueira4141. Vasconcelos DF, Junqueira LF Jr. Funções autonômica cardíaca e mecânica ventricular na cardiopatia chagásica crônica assintomática. Arq Bras Cardiol. 2012;98(2):111-9.
|
2012 |
Brazil |
Prospective cross-sectional |
15 controls and 13 chagasic |
controls = 40-46 |
Yes |
Yes |
The sympathetic and parasympathetic depressions with preserved balance were associated with heart rate variability and increased left ventricular systolic diameter in Chagasic patients with cardiomyopathy, indicating that these depressions may precede and be independently more severe than ventricular dysfunction, with no causal association between this depression and dysfunction. |
chagasic = 35-49 |
Del Castillo et al.4242. Del Castillo JM, Silveira CA, Albuquerque ES. Rotação, twisting e torção miocárdica avaliados pela ecocardiografia bidimensional (speckle tracking). Rev Bras Ecocardiogr Imagem Cardiovasc. 2012;25(3):206-13.
|
2012 |
Brazil |
Prospective cross-sectional |
20 |
54.8 ± 13.5 |
Yes |
Yes |
Employing the speckle tracking technique, it was possible to prove reduction of twisting and torsional deformation of myocardial fibers in Chagas cardiomyopathy, thus differentiating it from ventricular hypertrophy |
Melo et al.4343. Melo LM, Souza GE, Valim LR, Moreira FP, Damico EA, Rocha TR, et al. Estudo de fatores pró-trombóticos e pró-inflamatórios na cardiomiopatia chagásica. Arq Bras Cardiol. 2010;95(5):655-62.
|
2010 |
Brazil |
Cross-sectional |
150 |
G1:51.02 ± 1.256 |
Yes |
Yes |
It was demonstrated that both groups had increased inflammatory activity, but there were no indications of greater prothrombotic status among chagasic patients. |
G2: 54.88 ± 0.8787 |