Key result
Left ventricular reverse remodeling occurred in 24.5% of patients with Chagas cardiomyopathy but was not associated with a reduction in long-term all-cause mortality (HR 0.76, 95% CI 0.45-1.28).
Why the study?
The impact of left ventricular reverse remodeling on the prognosis of Chagas cardiomyopathy is unknown.
Cohort (n=159)
No
Hazard Ratio: 0.76 (95% CI 0.45–1.28)
Absolute Event Rate: 46.2% vs 54.2%
p-value: p=0.303
LVRR may be prognostic in Chagas cardiomyopathy; leaves open whether targeting remodeling improves outcomes.
BACKGROUND: The impact of left ventricular reverse remodeling (LVRR) on the prognosis of Chagas cardiomyopathy is unknown. The aim of this study was to determine whether the presence of LVRR can predict mortality in these patients. METHODS: From January 2000 to December 2010, the medical charts of 159 patients were reviewed. LVRR was defined as an increase of left ventricular ejection fraction (LVEF) and a decrease of left ventricular end-diastolic diameter (LVDD) by two-dimensional echocardiography. No patient underwent cardiac resynchronization therapy or required mechanical ventricular assistance. RESULTS: At baseline, median (25th-75th) LVDD was 64 mm (59-70), and median LVEF was 33.2% (26.4-40.1). LVRR was detected in 24.5% of patients in a 40-month (26-64) median follow-up. In the LVRR group, LVDD decreased from 64 mm (59-68) to 60 mm (56-65; p < 0.001), and LVEF increased from 31.3% (24.1-39.0) to 42.5% (32.2-47.7; p < 0.001). However, LVRR was not associated with heart failure hospitalization, cardiogenic shock, heart transplantation, or mortality (p > 0.05 for all comparisons). The Cox proportional hazard model analysis identified only cardiogenic shock (hazard ratio [HR]: 2.41; 95% confidence interval [CI]: 1.51-3.85; p < 0.001) and serum sodium level (HR: 0.91; 95% CI: 0.86-0.96; p < 0.001) as independent predictors of all-cause mortality. CONCLUSIONS: Left ventricular reverse remodeling occurs in one quarter of patients with Chagas cardiomyopathy and have no impact on the outcomes of patients with this condition.
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A 2020 study conducted a cohort in Chagas cardiomyopathy (n=159). Left ventricular reverse remodeling (LVRR) vs. No LVRR was evaluated on All-cause mortality (HR 0.76, 95% CI 0.45-1.28, p=0.303). Left ventricular reverse remodeling occurred in 24.5% of patients with Chagas cardiomyopathy but was not associated with a reduction in long-term all-cause mortality (HR 0.76, 95% CI 0.45-1.28).
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