Electrocardiographic abnormalities in Chagas disease in the general population: A systematic review and meta-analysis.
Electrocardiographic abnormalities in Chagas disease in the general population: A systematic review and meta-analysis.
复制标题
DOI：
10.1371/journal.pntd.0006567
复制
发表时间：
2018-06
影响因子：
3.8
通讯作者：
Muka T
中科院分区：
文献类型：
--
作者：
Rojas LZ;Glisic M;Pletsch-Borba L;Echeverría LE;Bramer WM;Bano A;Stringa N;Zaciragic A;Kraja B;Asllanaj E;Chowdhury R;Morillo CA;Rueda-Ochoa OL;Franco OH;Muka T
恰加斯病（CD）是拉丁美洲的一个主要公共卫生问题，也是非流行国家潜在的严重威胁。尽管克罗恩病与心脏异常之间的关联已被广泛报道，但研究设计的多样性、样本量和质量对这些信息提出了挑战，需要对其进行更新和综合，这对于非流行国家的医生来说非常有用且相关，在这些国家，克罗恩病的医疗保健影响是真实存在但被忽视的。我们对基于人群的研究进行了系统回顾和荟萃分析，这些研究比较了一般人群中 CD 和非 CD 参与者的总体和特定心电图异常的发生率。系统地检索了六个数据库（EMBASE、Ovid Medline、Web of Science、Cochrane Central、Google Scholar 和 Lilacs）。包括观察性研究。使用随机效应模型计算优势比 (OR)。共纳入 49 项研究，其中 34,023 项（12,276 项 CD 和 21,747 项非 CD）。与非 CD 参与者 (24.1%; 95% CIs=23.5-24.7) 相比，CD 参与者总体心电图异常发生率更高 (40.1%; 95% CIs=39.2-41.0) (OR=2.78; 95% CIs=2.37-3.26)。在特定心电图异常中，完全性右束支传导阻滞（RBBB）（OR=4.60；95%CIs=2.97-7.11）、左前分支传导阻滞（LAFB）（OR=1.60；95%CIs=1.21-2.13）、完全性RBBB/LAFB组合（OR=3.34；95%CIs=1.76-6.35）的患病率，与 CD 相比，CD 患者的一级房室传导阻滞 (A-V B) (OR=1.71; 95%CIs=1.25-2.33)、心房颤动 (AF) 或扑动 (OR=2.11; 95%CIs=1.40-3.19) 和室性早搏 (VE) (OR=1.62; 95%CIs=1.14-2.30) 较高非裁谈会参与者。这项系统综述和荟萃分析提供了该领域的更新和综合。这项观察性研究表明，在恰加斯流行地区的普通人群中，与克氏锥虫感染相关的心电图异常（40.1%）的患病率显着过高，最常见的是心室（RBBB 和 LAFB）、A-V B（一级）结传导异常以及心律失常（AF 或扑动和 VE）。此外，儿童心电图改变的发生率与成人相似，表明心脏病发病较早。恰加斯病（CD）是拉丁美洲的一个主要公共卫生问题，也是非流行国家潜在的严重威胁。尽管克罗恩病与心脏异常之间的关联已被广泛报道，但研究设计的多样性、样本量和质量对这些信息提出了挑战，需要对其进行更新和综合，这对于非流行国家的医生来说非常有用且相关，在这些国家，克罗恩病的医疗保健影响是真实存在但被忽视的。我们系统地回顾和荟萃分析了基于人群的研究，这些研究比较了恰加斯病 (CD) 和非 CD 参与者之间心电图异常的患病率。选择了 49 项研究，其中包括 34,023 名独特的参与者。我们对观察性研究的荟萃分析表明，在恰加斯流行地区的一般人群中，CD 患者的心电图异常患病率比非 CD 参与者增加了近三倍，其中最常见的是心室（RBBB 和 LAFB）、A-V B（一级）结传导异常以及心律失常（AF 或扑动和 VE）。
Chagas disease (CD) is a major public health concern in Latin America and a potentially serious emerging threat in non-endemic countries. Although the association between CD and cardiac abnormalities is widely reported, study design diversity, sample size and quality challenge the information, calling for its update and synthesis, which would be very useful and relevant for physicians in non-endemic countries where health care implications of CD are real and neglected. We performed to systematically review and meta-analyze population-based studies that compared prevalence of overall and specific ECG abnormalities between CD and non-CD participants in the general population. Six databases (EMBASE, Ovid Medline, Web of Science, Cochrane Central, Google Scholar and Lilacs) were searched systematically. Observational studies were included. Odds ratios (OR) were computed using random-effects model. Forty-nine studies were selected, including 34,023(12,276 CD and 21,747 non-CD). Prevalence of overall ECG abnormalities was higher in participants with CD (40.1%; 95%CIs=39.2-41.0) compared to non-CD (24.1%; 95%CIs=23.5-24.7) (OR=2.78; 95%CIs=2.37-3.26). Among specific ECG abnormalities, prevalence of complete right bundle branch block (RBBB) (OR=4.60; 95%CIs=2.97-7.11), left anterior fascicular block (LAFB) (OR=1.60; 95%CIs=1.21-2.13), combination of complete RBBB/LAFB (OR=3.34; 95%CIs=1.76-6.35), first-degree atrioventricular block (A-V B) (OR=1.71; 95%CIs=1.25-2.33), atrial fibrillation (AF) or flutter (OR=2.11; 95%CIs=1.40-3.19) and ventricular extrasystoles (VE) (OR=1.62; 95%CIs=1.14-2.30) was higher in CD compared to non-CD participants. This systematic review and meta-analysis provides an update and synthesis in this field. This research of observational studies indicates a significant excess in prevalence of ECG abnormalities (40.1%) related to T. cruzi infection in the general population from Chagas endemic regions, being the most common ventricular (RBBB and LAFB), and A-V B (first-degree) node conduction abnormalities as well as arrhythmias (AF or flutter and VE). Also, prevalence of ECG alterations in children was similar to that in adults and suggests earlier onset of cardiac disease. Chagas disease (CD) is a major public health concern in Latin America and a potentially serious emerging threat in non-endemic countries. Although the association between CD and cardiac abnormalities is widely reported, study design diversity, sample size and quality challenge the information, calling for its update and synthesis, which would be very useful and relevant for physicians in non-endemic countries where health care implications of CD are real and neglected. We systematically reviewed and meta-analyzed population-based studies that compared prevalence of ECG abnormalities between Chagas disease (CD) and non-CD participants. Forty-nine studies were selected, including 34,023 unique participants. Our meta-analysis of observational studies indicates CD presented almost a threefold increase prevalence of ECG abnormalities than non-CD participants in the general population from Chagas endemic regions, being the most common ventricular (RBBB and LAFB), and A-V B (first-degree) node conduction abnormalities as well as arrhythmias (AF or flutter and VE).
登录
查看更多内容
DOI：
10.1590/s0037-86822011000600008
发表时间：
2011-12-01
影响因子：
2
作者：
Tobar, Iván Bravo;Parra, Freddy;Bonfante-Cabarcas, Rafael
通讯作者：
Bonfante-Cabarcas, Rafael
影响因子：
6
作者：
Chatelain E
通讯作者：
Chatelain E
影响因子：
3.5
作者：
Echeverria, Luis E.;Rojas, Lyda Z.;Franco, Oscar H.
通讯作者：
Franco, Oscar H.
影响因子：
3.7
作者：
Molina-Garza ZJ;Rosales-Encina JL;Mercado-Hernández R;Molina-Garza DP;Gomez-Flores R;Galaviz-Silva L
通讯作者：
Galaviz-Silva L
影响因子：
3.2
作者：
Erazo, Diana;Cordovez, Juan
通讯作者：
Cordovez, Juan