Objective: To determine the prevalence and the prognostic value of exercise-induced ventricular arrhythmia (EIVA) in chronic Chagas' heart disease.
Study Design And Setting: An open prospective cohort of 130 clinically stable patients at a University Hospital outpatient unit in Rio de Janeiro, Brazil, was followed up at scheduled clinical visits from 1990 through 2007. The endpoint was total cardiovascular mortality. Survival curves (Kaplan-Meier) and a multivariate Cox proportional hazard model were adjusted to determine the association between EIVA and mortality.
Results: The median duration of follow-up was 9.9 years (range, 132 days to 17 years). EIVA prevalence was 43.1% (95% CI: 34.5-51.7). Thirty-three cardiovascular deaths (25.4%) occurred. The hazard ratio of EIVA for cardiovascular death, after adjustment for age, was 1.84 (P = 0.09). An interaction was found between EIVA and cardiomegaly on x-ray. In the group with cardiomegaly, the hazard of dying was four times greater in the presence of EIVA (P for interaction = 0.05).
Conclusion: In clinically stable chagasic subjects with cardiomegaly, EIVA is a clinically significant marker of total cardiovascular mortality and may be a useful risk stratification tool in this population.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/j.1540-8159.2011.03171.x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Exercise-induced dynamic mitral regurgitation is associated with outcomes in patients with ischaemic cardiomyopathy.
ESC Heart Fail
January 2025
Department of Cardiology, Pulmonology and Vascular Medicine, University Hospital Duesseldorf, Duesseldorf, Germany.
Aims: Ischaemic mitral regurgitation (MR) is a dynamic condition influenced by global and regional left ventricular remodelling as well as mitral valvular deformation. Exercise testing plays a substantial role in assessing the haemodynamic relevance of MR and is recommended by current guidelines. We aimed to assess the prevalence, haemodynamic consequences, and prognostic impact of dynamic MR using isometric handgrip exercise.
View Article and Find Full Text PDFExercise-Induced Oxygen Desaturation and Outcomes After Nintedanib Therapy for Fibrosing Interstitial Lung Disease in Patients Without Dyspnea.
J Clin Med
December 2024
Division of Respirology, Neurology and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Asahi-Machi 67, Kurume 830-0011, Japan.
The degree of exercise-induced oxygen desaturation and outcomes following antifibrotic drug therapy in asymptomatic patients with fibrosing interstitial lung disease (FILD) remain unclear. We compared clinical data, incidence of annual FILD progression, overall survival, and tolerability after initiating nintedanib between 58 patients with dyspnea and 18 patients without. Annual FILD progression was defined as >10% decrease in forced vital capacity (FVC), >15% decrease in diffusing capacity of the lungs for carbon monoxide (D), developing acute exacerbations, or FILD-related death within 1 year of starting nintedanib.
View Article and Find Full Text PDFPredictive factors of progression in mild fibrosing interstitial lung disease patients with gender-age-physiology score of 3 or less.
Respir Investig
January 2025
Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
Article Synopsis
- The study aimed to identify prognostic factors for annual progression in mild fibrosing interstitial lung disease (FILD) using retrospective data and logistic regression analysis.
- Significant factors associated with progression included the diagnosis of specific lung diseases, patient-reported outcomes, changes in lung function tests, and the CT scan's appearance.
- The findings suggest that factors such as exercise-induced hypoxia, radiological patterns, and certain disease diagnoses are key predictors of how FILD may worsen over time.
Prognostic value of the 6-min walk test derived attributes in patients with idiopathic pulmonary fibrosis.
Respir Med
January 2025
Department of Pulmonology, St. Antonius Hospital, Interstitial Lung Diseases Center of Excellence, Member of European Reference Network-Lung, Nieuwegein, the Netherlands; Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands.
Article Synopsis
- Idiopathic pulmonary fibrosis (IPF) is a severe lung disease linked to decreased physical ability and oxygen levels, both of which can predict survival rates in patients, especially when treated with antifibrotic drugs.
- This study analyzed data from patients who underwent a 6-minute walk test (6MWT) between 2015 and 2020 to evaluate how well certain test outcomes correlated with survival over two years.
- Results indicate that specific metrics from the 6MWT, particularly the minimal oxygen saturation during exercise (SpO-nadir), effectively predict mortality risk; incorporating SpO-nadir into existing survival models enhances their accuracy for clinical use in IPF care.
Invasive haemodynamic assessment in heart failure with preserved ejection fraction.
ESC Heart Fail
November 2024
Division of Cardiology, Department of Internal Medicine, Duke University School of Medicine, Durham, North Carolina, USA.
Despite the increasing prevalence and substantial burden of heart failure with preserved ejection fraction (HFpEF), which constitutes up to 50% of all heart failure cases, significant challenges persist in its diagnostic and therapeutic strategies. These difficulties arise primarily from the heterogeneous nature of the condition, the presence of various comorbidities and a wide range of phenotypic variations. Considering these challenges, current international guidelines endorse the utilization of invasive haemodynamic assessments, including resting and exercise haemodynamics, as the gold standard for enhancing diagnostic accuracy in cases where traditional diagnostic methods yield inconclusive results.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!