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Comparison of outcome between Chagas cardiomyopathy and idiopathic dilated cardiomyopathy

Amanda Pires Barbosa1, Augusto Cardinalli Neto, Ana Paula Otaviano

  • 1Hospital de Base de São José do Rio Preto, São José do Rio Preto, SP, Brazil. amandapbarbosa@yahoo.com.br

Arquivos Brasileiros De Cardiologia
|October 28, 2011
PubMed

Insights

Patients with Chagas cardiomyopathy face worse outcomes than those with idiopathic dilated cardiomyopathy, even with modern heart failure treatments. This study highlights the critical need for targeted therapies for Chagas cardiomyopathy patients.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Chagas cardiomyopathy outcomes are poorly understood compared to idiopathic dilated cardiomyopathy.
  • Contemporary data on Chagas cardiomyopathy prognosis is limited.

Purpose of the Study:

  • To compare the prognosis of Chagas cardiomyopathy patients with chronic systolic heart failure to those with idiopathic dilated cardiomyopathy.
  • Evaluate outcomes in the current era of heart failure management.

Main Methods:

  • Prospective follow-up of 352 patients (246 Chagas cardiomyopathy, 106 idiopathic dilated cardiomyopathy) from 2000-2008.
  • All patients received standard contemporary medical therapy for heart failure.

Main Results:

  • Chagas cardiomyopathy etiology (HR=3.29) and digoxin use (HR=3.17) were associated with increased mortality.
  • Beta-blocker therapy (HR=0.39) was associated with decreased mortality.
  • Survival probabilities at 49 months were 41% for Chagas cardiomyopathy vs. 82% for idiopathic dilated cardiomyopathy (p<0.005).

Conclusions:

  • Patients with Chagas cardiomyopathy exhibit a poorer prognosis than those with idiopathic dilated cardiomyopathy.
  • Current heart failure therapies do not fully mitigate the adverse outcomes in Chagas cardiomyopathy.
  • Further research into specific treatments for Chagas cardiomyopathy is warranted.
Abstract

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