Arq. Bras. Cardiol. 2017; 108(3): 246-254

Prognostic Factors in Severe Chagasic Heart Failure

Sandra de Araújo Costa, Salvador Rassi, Elis Marra da Madeira Freitas, Natália da Silva Gutierrez, Fabiana Miranda Boaventura, Larissa Pereira da Costa Sampaio, João Bastista Masson Silva

DOI: 10.5935/abc.20170027

Abstract

Background:

Prognostic factors are extensively studied in heart failure; however, their role in severe Chagasic heart failure have not been established.

Objectives:

To identify the association of clinical and laboratory factors with the prognosis of severe Chagasic heart failure, as well as the association of these factors with mortality and survival in a 7.5-year follow-up.

Methods:

60 patients with severe Chagasic heart failure were evaluated regarding the following variables: age, blood pressure, ejection fraction, serum sodium, creatinine, 6-minute walk test, non-sustained ventricular tachycardia, QRS width, indexed left atrial volume, and functional class.

Results:

53 (88.3%) patients died during follow-up, and 7 (11.7%) remained alive. Cumulative overall survival probability was approximately 11%. Non-sustained ventricular tachycardia (HR = 2.11; 95% CI: 1.04 – 4.31; p<0.05) and indexed left atrial volume ≥ 72 mL/m² (HR = 3.51; 95% CI: 1.63 – 7.52; p<0.05) were the only variables that remained as independent predictors of mortality.

Conclusions:

The presence of non-sustained ventricular tachycardia on Holter and indexed left atrial volume > 72 mL/m² are independent predictors of mortality in severe Chagasic heart failure, with cumulative survival probability of only 11% in 7.5 years.