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Survival and predictors of survival in patients with congestive heart failure due to Chagas' cardiomyopathy


, : Survival and predictors of survival in patients with congestive heart failure due to Chagas' cardiomyopathy. Circulation 90(6): 3098-3102

Background: The fundamental determinant of the natural history of Chagas' disease is cardiac involvement. Methods and Results: We studied 104 male patients with congestive heart failure due to Chagas' disease to estimate the survival distribution function and to evaluate age, functional class (FC), maximal oxygen consumption ( ovrhdot VO-2max), and ejection fraction (EF) as predictors of survival. Statistical evaluation was performed through univariate (Student's t test and chi-2 test) and multivariate analyses (Cox's regression model). Overall survival was 66% at 1 year, 56% at 3 years, and 48% at 5 years. Ages were not statistically different (P=.9811) between survivor (40.3+-8.7) and nonsurvivor (40.3+-9.4) groups. The ejection fraction(s) were statistically different (P=.0001) between survival (43.6+-9.9) and nonsurvival (30.6+-8.1) groups, as was ovrhdot VO-2max (P=.0001) (21.0+-4.7 and 15.0+-4.9, respectively). Most of the surviving patients were in FC II and most of the nonsurvivors were in FC IV (P=.0001). ovrhdot VO-2max (P=.0001) and EF (P=.0008) are highly associated with survival time in the multivariate analysis, but FC (P=.0578) is less important. Age (P=.9811) did not influence survival. Conclusions: We conclude that 50% of the patients with heart failure due to Chagas' disease die in 47 months and that ovrhdot VO-2max and EF are important indices of survival in this group.

US$19.90

PMID: 7994859

DOI: 10.1161/01.cir.90.6.3098


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