NDLVC in chronic Chagas disease was associated with higher 60-month survival than dilated cardiomyopathy (59% vs 30%, p=0.04); beta-blocker therapy predicted lower mortality (HR 0.16).
Cohort (n=215)
No
What are the clinical characteristics and survival outcomes of patients with non-dilated left ventricular cardiomyopathy secondary to chronic Chagas disease compared to those with dilated cardiomyopathy?
Non-dilated left ventricular cardiomyopathy accounts for 10% of heart failure in chronic Chagas disease and is associated with significantly better 5-year survival (59%) compared to the dilated phenotype (30%).
Absolute Event Rate: 59% vs 30%
p-value: p=0.04
Abstract Aims The aim of this investigation was to establish the clinical characteristics and outcomes of patients with non-dilated left ventricular cardiomyopathy (NDLVC) secondary to chronic Chagas disease (CChD). Methods and Results All patients with CChD followed at our institution from January 2000 to January 2010 were included. Patients with a Left Ventricular Ejection Fraction (LVEF) 50%, a left ventricular diastolic diameter (LVDD) 55 mm, and segmental wall motion abnormalities (SWMA) on echocardiography were diagnosed with NDLVC secondary to CChD. The remaining patients had Dilated Cardiomyopathy (DCM) secondary CChD. Of the 215 patients, 21 (10%) had NDLVC. In this group, the mean age was 62 ± 9 years, 12 (57%) were male, the median daily dose of metoprolol was 100 (62,5, 125) mg, the LVDD was 51 ± 29 mm, and the LVEF was 39 ± 6.4%. SWMA were found in 12 (57%) patients. Mean follow up 50.8 ± 3.8 months, during which 9 (43%) patients died. In a Cox regression model, BetaBlocker therapy was the only independent predictor of all-cause mortality for patients with NDLVC (HR=0.16, 95% CI 0.04 to 0.68; p =0.01) Over a 60-month follow-up, Kaplan-Meier survival estimates at 12, 24, 36, 48, and 60 months, were 71%, 71%, 59%, 59%, and 59%, respectively, in patients with NDLVC, and 77%, 61%, 49%, 38%, and 30%, respectively, in those with DCM due to CChD (p=0.04). Conclusions NDLVC affects one in 10 patients with CHF due to CChD, and the 5-year survival rate is 59%.
Bestetti et al. (Fri,) conducted a cohort in Chronic Chagas disease and heart failure with reduced left ventricular ejection fraction (n=215). Non-dilated left ventricular cardiomyopathy (NDLVC) vs. Dilated cardiomyopathy (DCM) was evaluated on Survival at 60 months (p=0.04). NDLVC in chronic Chagas disease was associated with higher 60-month survival than dilated cardiomyopathy (59% vs 30%, p=0.04); beta-blocker therapy predicted lower mortality (HR 0.16).