Chagas cardiomyopathy in the context of the chronic disease transition.

Abstract:

BACKGROUND:Patients with Chagas disease have migrated to cities, where obesity, hypertension and other cardiac risk factors are common. METHODOLOGY/PRINCIPAL FINDINGS:The study included adult patients evaluated by the cardiology service in a public hospital in Santa Cruz, Bolivia. Data included risk factors for T. cruzi infection, medical history, physical examination, electrocardiogram, echocardiogram, and contact 9 months after initial data collection to ascertain mortality. Serology and PCR for Trypanosoma cruzi were performed. Of 394 participants, 251 (64%) had confirmed T. cruzi infection by serology. Among seropositive participants, 109 (43%) had positive results by conventional PCR; of these, 89 (82%) also had positive results by real time PCR. There was a high prevalence of hypertension (64%) and overweight (body mass index [BMI] >25; 67%), with no difference by T. cruzi infection status. Nearly 60% of symptomatic congestive heart failure was attributed to Chagas cardiomyopathy; mortality was also higher for seropositive than seronegative patients (p = 0.05). In multivariable models, longer residence in an endemic province, residence in a rural area and poor housing conditions were associated with T. cruzi infection. Male sex, increasing age and poor housing were independent predictors of Chagas cardiomyopathy severity. Males and participants with BMI

journal_name

PLoS Negl Trop Dis

authors

Hidron AI,Gilman RH,Justiniano J,Blackstock AJ,Lafuente C,Selum W,Calderon M,Verastegui M,Ferrufino L,Valencia E,Tornheim JA,O'Neal S,Comer R,Galdos-Cardenas G,Bern C,Chagas Disease Working Group in Peru and Bolivia.

doi

10.1371/journal.pntd.0000688

subject

Has Abstract

pub_date

2010-05-18 00:00:00

pages

e688

issue

5

eissn

1935-2727

issn

1935-2735

journal_volume

4

pub_type

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