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Does left ventricular reverse remodeling influence long-term outcomes in patients with Chagas cardiomyopathy?

Marcelo Arruda Nakazone1,2, Ana Paula Otaviano3, Maurício Nassau Machado4

  • 1Postgraduate Division, São José do Rio Preto Medical School, São José do Rio Preto, SP, Brazil. manakazone@gmail.com.

Cardiology Journal
|March 25, 2020
PubMed

Insights

Left ventricular reverse remodeling (LVRR) occurs in nearly a quarter of Chagas cardiomyopathy patients. However, LVRR does not improve prognosis or reduce mortality in this population.

Area of Science:

  • Cardiology
  • Cardiovascular Diseases
  • Echocardiography

Background:

  • Chagas cardiomyopathy is a significant cause of heart failure.
  • The prognostic value of left ventricular reverse remodeling (LVRR) in Chagas cardiomyopathy remains unclear.
  • Understanding factors influencing outcomes is crucial for patient management.

Purpose of the Study:

  • To investigate the prevalence of LVRR in Chagas cardiomyopathy patients.
  • To determine if LVRR predicts mortality or other adverse outcomes.
  • To identify independent predictors of mortality in this cohort.

Main Methods:

  • Retrospective review of 159 Chagas cardiomyopathy patients' medical records (2000-2010).
  • LVRR defined by echocardiographic changes: increased left ventricular ejection fraction (LVEF) and decreased left ventricular end-diastolic diameter (LVDD).
  • Cox proportional hazard models used to assess predictors of all-cause mortality.

Main Results:

  • LVRR was observed in 24.5% of patients over a median follow-up of 40 months.
  • LVRR was associated with significant improvements in LVEF and LVDD (p < 0.001).
  • LVRR did not correlate with reduced heart failure hospitalization, cardiogenic shock, heart transplantation, or mortality (p > 0.05).
  • Independent predictors of mortality included cardiogenic shock (HR: 2.41) and lower serum sodium levels (HR: 0.91).

Conclusions:

  • Left ventricular reverse remodeling is a common finding in Chagas cardiomyopathy.
  • LVRR does not appear to influence the long-term prognosis or survival of patients with Chagas cardiomyopathy.
  • Cardiogenic shock and low serum sodium are significant predictors of mortality.
Abstract

Keywords:
Chagas cardiomyopathyheart failureleft ventricular remodelingmortalityprognosis

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