Repolarization parameters are associated with mortality in chagas disease patients in the United States

Area of Science:

• Cardiology
• Infectious Diseases
• Electrocardiography

Background:

• Chagas disease (CD) is a parasitic infection with significant cardiac implications.
• Cardiac involvement in CD can lead to cardiomyopathy (CM) and conduction abnormalities like bundle branch block (BBB).
• Early identification of mortality risk in CD patients is crucial for timely management.

Purpose of the Study:

• To investigate the association between specific electrocardiogram (ECG) repolarization parameters and mortality or the need for cardiac transplant in Chagas disease patients living in the United States.
• To compare ECG findings in CD patients with cardiomyopathy or bundle branch block against age- and sex-matched controls.

Main Methods:

• The study included Chagas disease patients with cardiomyopathy (CM) and/or bundle branch block (BBB), compared to controls.
• Key ECG parameters measured included QT interval, QT dispersion (QTd), T wave peak to T wave end duration (Tp-Te), and Tp-Te dispersion ((Tp-Te)d).
• Fractionated QRS (fQRS) was also assessed, and the primary outcome was mortality or need for cardiac transplant.

Main Results:

• CD patients with CM showed significantly prolonged QTd, Tp-Te, and (Tp-Te)d compared to controls.
• Chagas CM patients also exhibited a higher prevalence of fQRS.
• CD patients with BBB had longer QTd and (Tp-Te)d than BBB controls.
• Univariate analysis revealed that QTd and (Tp-Te)d were associated with increased risk of death or cardiac transplant.

Conclusions:

• Prolonged QT dispersion and Tp-Te dispersion are significant electrocardiographic markers associated with adverse outcomes in Chagas disease patients.
• These ECG parameters can aid in risk stratification for mortality and the need for cardiac transplantation in CD.
• The findings highlight the utility of specific ECG repolarization metrics in managing Chagas disease cardiac complications.