CARDIAC MORBIDITY AND MORTALITY DUE TO CHAGAS-DISEASE - PROSPECTIVE ELECTROCARDIOGRAPHIC STUDY OF A BRAZILIAN COMMUNITY
CARDIAC MORBIDITY AND MORTALITY DUE TO CHAGAS-DISEASE - PROSPECTIVE ELECTROCARDIOGRAPHIC STUDY OF A BRAZILIAN COMMUNITY
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DOI：
10.1161/01.cir.75.6.1140
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发表时间：
1987-06-01
期刊：
影响因子：
37.8
通讯作者：
WELLER, TH
中科院分区：
文献类型：
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作者：
MAGUIRE, JH;HOFF, R;WELLER, TH
Chagas '心肌病的演变知之甚少。因此，我们研究了心脏病变的发展，在巴西农村社区为期7年。最初，1017名居民中有42%的克氏锥虫感染血清反应呈阳性。特定人群的感染率表明，大多数人在20岁之前就被感染了。在随访中发现，出现心脏病变的患者在感染后不久即出现心脏病变，因为右束分支传导阻滞和其他心室传导缺陷（VCD）的发生率在20岁之前也最高。这些病变的进行性表现为在成人VCD感染者中频繁出现额外的心电图异常和高死亡率。相比之下，60岁以下心电图正常的血清阳性和血清阴性成人的死亡率较低，大致相同。在感染的早期无症状阶段的心电图能够区分具有潜在致命心脏病变的人与具有良性预后的人。
The evolution of Chagas'' cardiomyopathy is poorly understood. We therfore examined the development of cardiac lesions in a rural Brazilian community for a period of 7 years. Initially , 42% of 1017 residents were seropositive for infection with Trypanosoma cruzi. Age-specific infection rates indicated that most had become infected before the age of 20 years. On follow-up, it appeared that those persons who developed cardiac lesions did so soon after infection, since the incidence of right bundle branch block and other ventricular conduction defects (VCDs) was also highest before age 20 years. The progressive nature of these lesions was demonstrated by frequent development of additional electrocardiographic abnormalities and high mortality among infected adults with VCDs. In contrast, mortality was low and approximately the same for seropositive and seronegative adults under 60 years who had normal electrocardiograms. Electrocardiography during the early asymptomatic stage of infection was able to distinguish persons with potentially lethal cardiac lesions from those with a benign prognosis.