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Electrocardiographic alterations in chronically Trypanosoma cruzi-infected persons exposed to cardiovascular factors
H Berra1, F Carnevali, S Revelli
1Sanatorio Regional Rosendo García, Rosario, Argentina.
Insights
Associated risk factors did not increase cardiac risk in T. cruzi-infected individuals. However, these factors led to ECG abnormalities in seronegative individuals, suggesting a potential link to chagasic-compatible changes.
Area of Science:
- Cardiology
- Infectious Diseases
- Epidemiology
Background:
- Chagasic cardiomyopathy (CC) is a significant health concern.
- Associated risk factors (ARF) like smoking and hypertension may influence CC development.
- Understanding these influences is crucial for risk stratification and management.
Purpose of the Study:
- To investigate the impact of associated risk factors (ARF) on the development of chronic chagasic cardiomyopathy (CC).
- To analyze the association between ARF and electrocardiogram (ECG) abnormalities in T. cruzi-infected and seronegative individuals.
Main Methods:
- Analysis of 124 individuals from endemic areas of Northern Argentina.
- Classification into four groups based on T. cruzi serology and ARF status.
- Assessment included clinical exams, ARF criteria, serology, chest X-ray, and ECG.
Main Results:
- No statistical differences in age, residence, or ARF distribution among groups.
- Abnormal ECGs were significantly more frequent in T. cruzi-infected and seronegative individuals with ARF compared to seronegative individuals without ARF.
- ARF did not significantly increase the odds of abnormal ECG in T. cruzi-infected individuals.
Conclusions:
- Associated risk factors do not elevate cardiac risk in chronically T. cruzi-infected individuals.
- ARF were associated with chagasic-compatible ECG abnormalities in seronegative individuals.
- Further research is needed to elucidate the role of ARF in Chagas disease progression.
Methods:
We analyzed the potential influence that associated risk factors (ARF), such as smoking, alcoholism, overweight, and hypertension, could have on the establishment of chronic chagasic cardiomyopathy (CC). The sample was comprised of 124 individuals, 69 males and 55 females (mean age +/- SD, 41 +/- 9.5 years), who were born in en demic areas of Northern Argentina and migrated further to Rosario City, an area where autochthonous cases of Chagas' disease have never been registered. Assessments included the following: clinical examination to discard previous cardiomyopathies; search for the presence of ARF according to standard criteria; specific serology; frontal chest X-ray, and 12-lead resting electrocardiogram (ECG). Subjects were classified on the basis of their serological status and presence of ARF into four groups: Tc+ARF+ T. cruzi-infected persons with ARF (n = 41); Tc-ARF+ seronegativity in presence of ARF (n = 27); Tc+ARF- individuals showing positive serology that lacked ARF (n = 27), and Tc-ARF- seronegative individuals having no ARF (n = 29).
Results:
Except for a higher female/male ratio in groups presenting no ARF (p < 0.02), no statistical differences as to age, length of residence in endemicity areas (LR), and ARF distribution were recorded among groups. Forty-one persons presented abnormal ECG tracings, distributed thus: Tc+ARF+, 18/41; Tc-ARF+, 14/27, Tc+ARF-, 14/27, and Tc-ARF, 4/29 (p < 0.01, in relation to the latter group). Subjects from the Tc+ARF+, Tc-ARF+, and Tc+ARF- groups had 4.89-, 6.7-, and 6.7-fold increases, respectively, if having an abnormal ECG when compared with Tc-ARF- individuals. Comparisons on the frequency of abnormal ECG between seropositives carrying ARF or not yielded a non-significant odds ratio, be it estimated as crude, or after adjusting for sex, age, and LR in multivariate analysis.
Conclusions:
Presence of ARF was not associated with an increasing risk of cardiac affectation in chronically T. cruzi-infected persons, but resulted in chagasic-compatible ECG abnormalities in those seronegative individuals.