Impact of cardiac structure and function on exercise intolerance in Chagas cardiomyopathy: Insights from CPET and echocardiography.

Autor: Pereira JM; Federal University of Minas Gerais, Belo Horizonte, Brazil., Magnani EF; Federal University of Minas Gerais, Belo Horizonte, Brazil., Tanaka DM; Medical School of Ribeirão Preto - University of São Paulo, Ribeirão Preto, Brazil., Damasceno TR; Federal University of Minas Gerais, Belo Horizonte, Brazil., Oliveira RDB; Federal University of Minas Gerais, Belo Horizonte, Brazil., Carvalho EEV; Federal University of Triângulo Mineiro, Uberaba, MG, Brazil., Pereira DAG; Federal University of Minas Gerais, Belo Horizonte, Brazil., Costa HS; Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil., Gadioli LP; Medical School of Ribeirão Preto - University of São Paulo, Ribeirão Preto, Brazil., Azevedo ER; Medical School of Ribeirão Preto - University of São Paulo, Ribeirão Preto, Brazil., Crescêncio JC; Medical School of Ribeirão Preto - University of São Paulo, Ribeirão Preto, Brazil., Gallo Júnior L; Medical School of Ribeirão Preto - University of São Paulo, Ribeirão Preto, Brazil., Simões MV; Medical School of Ribeirão Preto - University of São Paulo, Ribeirão Preto, Brazil., de Oliveira LFL; Federal University of Minas Gerais, Belo Horizonte, Brazil; Federal University of Triângulo Mineiro, Uberaba, MG, Brazil. Electronic address: oliveiralfl@hotmail.com.
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2024 Dec 01; Vol. 416, pp. 132488. Date of Electronic Publication: 2024 Aug 25.
DOI: 10.1016/j.ijcard.2024.132488
Abstrakt: Introduction: Chronic Chagas cardiomyopathy (CCC), the most severe clinical condition of Chagas disease, often leads to a reduction in functional capacity and the appearance of symptoms such as fatigue and dyspnea on exertion. However, its determinant factors remain unclear. We aimed to evaluate the peak oxygen consumption (VO 2peak ) in patients with CCC and identify its determining factors.
Methods: An observational study with 97 CCC patients was conducted. Patients underwent clinical examination, cardiopulmonary exercise test (CPET), and echocardiography as part of the standard clinical evaluation. Multivariate linear regression was used to identify independent clinical and echocardiographic predictors of VO 2peak and percentage of predicted VO 2 .
Results: Mean age of study patients was 55.9 ± 13.4 years, median left ventricle ejection fraction (LVEF) was 40 (26-61.5) % and median VO 2peak was 16.1 (12.1-20.8) ml/Kg/min. 36 patients presented preserved LVEF and 61 presented reduced LVEF. There were significant differences in almost all CPET variables (p < 0.05) between these two groups. VO 2peak was associated with age, male sex, NYHA functional class, LVEF, left atrium diameter, LV diastolic diameter, E wave, LV mass index, and pulmonary artery systolic pressure (PASP). Age, male sex, LVEF, and E wave remained independently associated with VO 2peak in the multivariate analysis (R 2  = 0.69), furthermore, only LVEF and E wave were associated with the predicted VO 2 percentage (R 2  = 0.53).
Conclusion: In patients with CCC, disease severity, male sex, LV systolic and diastolic function influence the functional capacity.
Competing Interests: Declaration of competing interest All authors declare no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024. Published by Elsevier B.V.)
Databáze: MEDLINE
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