Insuficiência Cardíaca Aguda em Pacientes com Cardiomiopatia Chagásica: Resultados do I Registro Brasileiro de Insuficiência Cardíaca (BREATHE)
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Although the clinical features of chronic Chagas' cardiomyopathy (CCC) have been well established, clinical data about the patients are scarce. OBJECTIVES: The current analysis reports the results of the I Brazilian Heart Failure Registry (BREATHE) assessing baseline characteristics and clinical outcomes of patients with acute heart failure due to CCC. METHODS: BREATHE enrolled a total of 3,013 adult patients hospitalized with acute heart failure. We analyzed comparatively 261 (8.7%) patients with chronic CCC and 2,752 (91.3%) patients with other etiologies. Clinical and demographic information, cardiac structure/function data on echocardiogram and outcomes during the hospital stay and after discharge were assessed in both groups. Uni and multivariate tests were performed and a p-value <0.05 was considered statistically significant. RESULTS: Patients with CCC presented lower systolic blood pressure (108.3 ± 26.1 vs 128.3 ± 30.3 mmHg, p<0.001) and left ventricle ejection fraction (25.4 [19 - 36]% vs 37 [27 - 54] %, p<0.001) with higher rates of jugular vein distension (54.8% vs 38.9%, p<0.001), hepatomegaly (47.9% vs 25.6%, p<0.001), and "cold and wet" clinical hemodynamic profile (27.2% vs 10.6%, p<0.001). Patients with CCC presented higher rate of the composite death or heart transplantation (17.4% vs. 11.1%, p=0.004), and higher cumulative incidence of death after 3 months (16.5% vs 10.8%, p=0.017), 6 months (25.3% vs 17.2%, p=0.006), and 12 months (39.4% vs 26.6%, p<0.001). Besides, CCC was independently associated with 12-month mortality risk with odds ratio = 2.02 (95% IC: 1.47-2.77). CONCLUSION: Patients with CCC, hospitalized due to acute heart failure, in comparison to other etiologies, presented a higher risk profile that was associated with a poorer outcome during hospital stay and after discharge.
Authors: Pedro Gabriel Melo de Barros e Silva, Denilson Campos Albuquerque, Renato Delascio Lopes, Paulo Roberto Nogueira, Aguinaldo F Freitas Jr, Carlos Vieira Nascimento, Charles Mady, Elizabete Silva dos Santos, Mauro Esteves Hernandes, Maria Alayde Mendonça Rivera, João David de Souza Neto, Alvaro Rabelo, Manoel Fernandes Canesin, Helder Reis, Anderson da Costa Armstrong, Conrado Hoffmann, Renato Hideo Nakagawa Santos, Isabella de Andrade Jesuino, Luis Eduardo Rohde, Lidia Zytinsky Moura, Fabiana Goulart Marcondes-Braga, Evandro Tinoco Mesquita, José Albuquerque de Figueiredo Neto, Ricardo Mourilhe-Rocha, Luís Beck-da-Silva, Mucio Tavares Oliveira Junior, Marcus Vinicius Simões
Institutions: Hospital do Coração, Centro Universitário São Camilo, Duke University, Universidade Federal de São Paulo, Faculdade de Medicina de São José do Rio Preto, Universidade Federal de Goiás, Instituto de Cardiologia do Distrito Federal, Universidade de São Paulo, Instituto Dante Pazzanese de Cardiologia, Santa Casa de Votuporanga, Universidade Federal de Alagoas, Hospital de Messejana, Universidade Federal do Vale do São Francisco, Hospital Regional Rancagua, Hospital Moinhos de Vento, Hospital de Clínicas de Porto Alegre, Universidade Federal Fluminense, Universidade Federal do Maranhão, Hospital Universitário Pedro Ernesto
Language: Portuguese
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4411210484