Incremental Prognostic Value of Echocardiography to Brain Natriuretic Peptide in Patients with Chagas Cardiomyopathy from Endemic Areas.
Incremental Prognostic Value of Echocardiography to Brain Natriuretic Peptide in Patients with Chagas Cardiomyopathy from Endemic Areas.
复制标题
超声心动图对流行地区恰加斯心肌病患者脑钠肽的增加预后价值。
DOI：
10.1016/j.echo.2022.05.008
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Nun
中科院分区：
文献类型：
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作者：
Maia,MarceloAlves;Sabino,EsterCerdeira;Oliveira,LeaCamposde;Oliveira,ClaudiaDiLorenzo;Cardoso,ClareciS;Maia,AnaIsabelNobre;Versiani,FellipeColaresPG;Silva,JoseLuizPadilhada;Ferreira,ArielaMota;Ribeiro,AntonioLuizP;Nun
查加斯病仍然是西半球最致命的寄生虫病之一，每年有数百万人死于这种疾病1。查加斯病的负担历来集中在拉丁美洲的穷人中，那里绝大多数病人获得保健的机会有限。查加斯心肌病是流行地区的主要死亡原因，主要由左心室功能障碍的严重程度预测2。超声心动图在南美锥虫病死亡危险分层中起重要作用3。然而，大多数患者生活在偏远地区，无法获得超声心动图。在这种情况下，利钠肽可以提供关于左心室功能和水肿的信息4。在本研究中，我们调查了超声心动图参数是否比N-末端proBNP提供更多的预后信息。来自低资源环境的查加斯心肌病患者的NT-proBNP测量：来自米纳斯吉拉斯北部流行区的查加斯病患者具有左心室射血分数（LVEF）< 50%和/或NT-ProBNP> 300 pg/ml的患者（SaMi-Trop队列研究）有资格参加该研究。使用标准化问卷获得临床数据。在基线时记录静息心电图（ECG）。在公共卫生初级中心使用便携式设备进行简化的超声心动图方案和容易获得的测量。终点为全因死亡率。
Chagas disease remains one of the most deadly parasitic diseases in the Western Hemisphere with millions of people dying annually from the disease1. The burden of Chagas disease has historically been concentrated among the poor in Latin America where the overwhelming majority of patients have limited access to health care. Chagas cardiomyopathy is the leading cause of death in endemic areas, which is mainly predicted by the severity of left ventricular dysfunction2. Echocardiography plays an important role on risk stratification of death in Chagas disease3. However, most patients live in remote areas with no access to echocardiography. In this context, natriuretic peptides may provide information on left ventricular function and prognosis4. In the present study we investigated whether echocardiographic parameters provide incremental prognostic information over N-terminal proBNP (NT-proBNP) measurement in patients with Chagas cardiomyopathy from lowresources setting.Patients with Chagas disease from endemic areas in the north of Minas Gerais (SaMi-Trop cohort study) who had left ventricular ejection fraction (LVEF)< 50% and/or NT-ProBNP> 300 pg/ml were eligible for the study. Clinical data were obtained using a standardized questionnaire. A resting electrocardiogram (ECG) was recorded at baseline. A simplified echocardiographic protocol with readily obtained measures was performed using portable equipment at public health primary centers. The end point was all-cause mortality.