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Non-dilated left ventricular cardiomyopathy in patients with chronic Chagas disease and heart failure with reduced

Reinaldo B Bestetti1,2, Augusto Cardinalli-Neto3, Ana Paula Otaviano3

  • 1Department of Medicine, University of Ribeirão Preto, Ribeirão Preto city 14096-900, Brazil.

ESC Heart Failure
|February 19, 2026
PubMed

Insights

Non-dilated left ventricular cardiomyopathy (NDLVC) affects 10% of chronic Chagas disease patients. Beta-blocker therapy significantly improves survival in NDLVC patients, highlighting its importance in managing this condition.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Echocardiography

Background:

  • Chronic Chagas disease (CChD) can lead to cardiomyopathy, a significant cause of heart failure.
  • Non-dilated left ventricular cardiomyopathy (NDLVC) is a less common manifestation of CChD compared to dilated cardiomyopathy (DCM).
  • Understanding the clinical profile and outcomes of NDLVC in CChD is crucial for patient management.

Purpose of the Study:

  • To define the clinical characteristics of patients with NDLVC secondary to CChD.
  • To evaluate the outcomes and mortality predictors in this patient group.
  • To compare survival rates between NDLVC and DCM in the context of CChD.

Main Methods:

  • Retrospective analysis of patients with CChD from 2000-2010.
  • Diagnosis of NDLVC based on echocardiographic criteria: LVEF <50%, LVDD <55 mm, and SWMA.
  • Survival analysis using Cox regression and Kaplan-Meier estimates.

Main Results:

  • NDLVC was identified in 10% (21/215) of CChD patients.
  • The mean age of NDLVC patients was 62 years, with 57% males.
  • Beta-blocker therapy was the sole independent predictor of reduced all-cause mortality in NDLVC (HR=0.16, P=.01).
  • Five-year survival for NDLVC was 59%, compared to 30% for DCM (P=.04).

Conclusions:

  • NDLVC occurs in approximately 10% of heart failure patients with CChD.
  • A 5-year survival rate of 59% was observed in NDLVC patients.
  • Beta-blocker therapy is associated with improved survival in NDLVC patients with CChD.
Abstract

Keywords:
Chagas cardiomyopathyChagas diseaseHeart failureInherited cardiomyopathyNon-dilated left ventricular cardiomyopathy

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