To evaluate asymptomatic patients with chronic Chagas‘ disease in relation to the prevalence of ventricular arrhythmia, left ventricular dysfunction, and B-type natriuretic peptide levels ( BNP).
Clinical evaluation, electrocardiogram (EKG). cardiothoracic index (CTI),dynamic electrocardiogram, echocardiogram and BNP dosing were used to evaluate 106 patients from the Chagas Disease Outpatient Clinic, distributed into three groups: GI (50- normal EKG). GIIA (31-EKG with alterations characteristic of Chagas disease, and GIIB ( 25- EKG with other types of alterations).
The most prevalent electrocardiographic alterations were: GIIA group: right bundle branch block, anterior division of de left bundle branch block and inactive areas (18% each); GIIB group: alterations in the infero-lateral repolarization and left ventricular hypertrophy (26%). CTI mean values were similar (p=0,383). The prevalence of ventricular arrhythmia was greater in the GIIA (77%) and GIIB (75%) groups than in the GI group (46%) (p=0,002). Ventricular dysfunction was more frequent in the GIIA (52%) and GIIB (32%) groups than in the GI group (14%) (p= 0,001). Systolic dysfunction was more prevalent in the GIIA group (29%) than in the GIIB (20%) and GI (2%) (p< 0,001). Diastolic dysfunction was more frequent in the GII (42%) and GIIB (28%) groups than in the GI (12%) group (p=0,005). B-type natriuretic peptide levels were 30 ± 88 pg/ml for the GI group, 66 ± 194 for the GIIA group and 24 ± 82 for the GIIB group (p=0,121), respectively.
Arrhythmia and left ventricular dysfunction were more prevalent in the asymptomatic patients with chronic Chagas‘ disease and EKG alterations than in patients with normal EKGs. BNP levels were similar among the groups.
Patients with asymptomatic chronic form of the Chagas‘disease and electrocardiographic alterations will have to be submitted to the inquiry in relation to the presence of arrhythmias and ventricular dysfunction.
Divina Oliveira-Marques, None.