Cardiac Involvement by Yellow Fever(from the PROVAR+ Study).

Area of Science:

• Cardiology
• Infectious Diseases
• Public Health

Background:

• Yellow Fever (YF) incidence is rising in Brazil.
• Cardiac complications like bradyarrhythmias and conduction abnormalities are noted in YF.
• Comprehensive cardiac evaluation in YF patients is needed to understand disease severity associations.

Purpose of the Study:

• To conduct a thorough cardiac assessment of patients hospitalized with Yellow Fever.
• To determine the relationship between cardiac involvement and Yellow Fever disease severity.

Main Methods:

• Seventy confirmed Yellow Fever patients underwent clinical and laboratory evaluation.
• Focused bedside echocardiography, electrocardiogram, and 24-hour Holter monitoring were utilized.
• Patients were stratified by disease severity; some had MRI or necropsy.

Main Results:

• Significant electrocardiogram abnormalities were more frequent in severe YF (77%) versus mild/moderate (52%).
• Bradycardia occurred in 24% of patients; 44% of Holter-monitored patients had heart rates below 60 bpm.
• Echocardiography showed left ventricular dysfunction in 6% of severe cases; myocardial infiltration signs were seen in 17 patients.

Conclusions:

• Cardiac involvement is common in Yellow Fever patients.
• Findings include bradycardia and myocardial texture changes suggestive of infiltration.
• These cardiac manifestations correlate with Yellow Fever disease severity.