Acute Heart Failure in Patients with Chagas Cardiomyopathy: Results of the I Brazilian Heart Failure Registry (BREATHE)

Abstract Background Although the clinical features of chronic Chagas’ cardiomyopathy (CCC) have been well established, clinical data about the patients are scarce. Objectives The current analysis reports the results of the I Brazilian Heart Failure Registry (BREATHE) assessing baseline characteristics and clinical outcomes of patients with acute heart failure due to CCC. Methods BREATHE enrolled a total of 3,013 adult patients hospitalized with acute heart failure. We analyzed comparatively 261 (8.7%) patients with chronic CCC and 2,752 (91.3%) patients with other etiologies. Clinical and demographic information, cardiac structure/function data on echocardiogram and outcomes during the hospital stay and after discharge were assessed in both groups. Uni and multivariate tests were performed and a p-value <0.05 was considered statistically significant. Results Patients with CCC presented lower systolic blood pressure (108.3 ± 26.1 vs 128.3 ± 30.3 mmHg, p<0.001) and left ventricle ejection fraction (25.4 [19 - 36]% vs 37 [27 - 54] %, p<0.001) with higher rates of jugular vein distension (54.8% vs 38.9%, p<0.001), hepatomegaly (47.9% vs 25.6%, p<0.001), and “cold and wet” clinical hemodynamic profile (27.2% vs 10.6%, p<0.001). Patients with CCC presented higher rate of the composite death or heart transplantation (17.4% vs. 11.1%, p=0.004), and higher cumulative incidence of death after 3 months (16.5% vs 10.8%, p=0.017), 6 months (25.3% vs 17.2%, p=0.006), and 12 months (39.4% vs 26.6%, p<0.001). Besides, CCC was independently associated with 12-month mortality risk with odds ratio = 2.02 (95% IC: 1.47-2.77). Conclusion Patients with CCC, hospitalized due to acute heart failure, in comparison to other etiologies, presented a higher risk profile that was associated with a poorer outcome during hospital stay and after discharge.

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Journal
Arquivos Brasileiros de Cardiologia
Published
2025-01-01
DOI
https://doi.org/10.36660/abc.20240555i
Citations
3
Primary Topic
Trypanosoma species research and implications
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article
Field-Weighted Citation Impact
4.06
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article

Acute Heart Failure in Patients with Chagas Cardiomyopathy: Results of the I Brazilian Heart Failure Registry (BREATHE)

Mauro Esteves Hernandes, Ari Nunes de Freitas, Carlos Nascimento, Múcio Tavares de Oliveira et al.
3 citations
Arquivos Brasileiros de Cardiologia
Trypanosoma species research and implications
4.06
article

Acute Heart Failure in Patients with Chagas Cardiomyopathy: Results of the I Brazilian Heart Failure Registry (BREATHE)

Mauro Esteves Hernandes, Ari Nunes de Freitas, Carlos Nascimento, Múcio Tavares de Oliveira, Manoel Fernandes Canesin, Evandro Tinoco Mesquita, Fabiana G. Marcondes‐Braga, Conrado Hoffmann, Ricardo Mourilhe‐Rocha, Lidia Zytinsky Moura, Isabella de Andrade Jesuíno, José Albuquerque de Figueiredo Neto, Charles Mady, Renato Hideo Nakagawa Santos, Anderson da Costa Armstrong, Renato D. Lópes, Luís Eduardo Paim Rohde, Pedro Gabriel Melo de Barros e Silva, Denílson Campos de Albuquerque, Luís Beck da Silva Neto, Marcus Vinı́cius Simões, Maria Alayde Mendonça Rivera, Paulo Roberto Nogueira, Helder José Lima Reis, Elizabete Silva dos Santos, João David de Souza Neto, Álvaro Rabelo
article en
3 citations

Abstract

Abstract Background Although the clinical features of chronic Chagas’ cardiomyopathy (CCC) have been well established, clinical data about the patients are scarce. Objectives The current analysis reports the results of the I Brazilian Heart Failure Registry (BREATHE) assessing baseline characteristics and clinical outcomes of patients with acute heart failure due to CCC. Methods BREATHE enrolled a total of 3,013 adult patients hospitalized with acute heart failure. We analyzed comparatively 261 (8.7%) patients with chronic CCC and 2,752 (91.3%) patients with other etiologies. Clinical and demographic information, cardiac structure/function data on echocardiogram and outcomes during the hospital stay and after discharge were assessed in both groups. Uni and multivariate tests were performed and a p-value <0.05 was considered statistically significant. Results Patients with CCC presented lower systolic blood pressure (108.3 ± 26.1 vs 128.3 ± 30.3 mmHg, p<0.001) and left ventricle ejection fraction (25.4 [19 - 36]% vs 37 [27 - 54] %, p<0.001) with higher rates of jugular vein distension (54.8% vs 38.9%, p<0.001), hepatomegaly (47.9% vs 25.6%, p<0.001), and “cold and wet” clinical hemodynamic profile (27.2% vs 10.6%, p<0.001). Patients with CCC presented higher rate of the composite death or heart transplantation (17.4% vs. 11.1%, p=0.004), and higher cumulative incidence of death after 3 months (16.5% vs 10.8%, p=0.017), 6 months (25.3% vs 17.2%, p=0.006), and 12 months (39.4% vs 26.6%, p<0.001). Besides, CCC was independently associated with 12-month mortality risk with odds ratio = 2.02 (95% IC: 1.47-2.77). Conclusion Patients with CCC, hospitalized due to acute heart failure, in comparison to other etiologies, presented a higher risk profile that was associated with a poorer outcome during hospital stay and after discharge.

Arquivos Brasileiros de CardiologiaVol. 122(5)
Universidade Federal Fluminense (BR), Universidade de São Paulo (BR), Universidade Brasil (BR), Hospital Moinhos de Vento (BR), Irmandade da Santa Casa de Misericórdia de São Paulo (BR), Clinical Research Institute (US), Instituto de Cardiologia do Distrito Federal (BR), Hospital de Clínicas de Porto Alegre (BR), Hospital Universitário Pedro Ernesto (BR), Hospital Universitário Regional do Norte do Paraná (BR), Fundação Bahiana de Infectologia (BR), Hospital de Messejana (BR), Santa Casa de Votuporanga (BR), Hospital do Coração (BR), Centro Universitário São Camilo (BR), Fundação Faculdade de Medicina (BR), Instituto Dante Pazzanese de Cardiologia (BR), Hospital de Clínicas (UY), Universidade Federal do Maranhão (BR), Universidade Federal do Vale do São Francisco (BR), Universidade Federal de Goiás (BR), Universidade Federal de Alagoas (BR)
Openalex Percentile: Top 6%
Trypanosoma species research and implications
4.06
DOIOpen Access PDFOpenAlex
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