Abstract
BackgroundChagas disease (CD) is a major cause of cardiomyopathy in Latin America, and migration movements have now spread the disease worldwide. However, data regarding Chagas cardiomyopathy (CC) and the usefulness of echocardiography in non endemic countries are still scarce.Methods and resultsWe selected 485 patients in the chronic phase of CD from two Spanish settings. Data from physical examination, electrocardiogram (EKG), x-ray, and two dimensional transthoracic echocardiogram were recorded. Trypanosoma cruzi DNA was assessed by PCR in peripheral blood. Patients were stratified according to the Kuschnir classification and a combination of echocardiogram and electrocardiogram findings. Patients mainly came from Bolivia (459; 94.6%). One hundred and forty three patients (31.5%) had at least one electrocardiogram abnormality. Twenty seven patients (5.3%) had an abnormal echocardiography. Patients with abnormal echocardiography were older (47 (IQR 38–57) years vs 41 (IQR 38–57) years); p = 0.019) and there was a greater proportion of males (66.7% vs 29.7%); p<0.001). Among echocardiographic variables, diastolic dysfunction was associated with poor cardiac status. In the multivariate analysis, abnormal EKG and gender were associated with abnormal echocardiography. Echocardiography may be spared for males under 30 and females under 45 years old with normal EKG as the likelihood of having an abnormal echocardiography is minimal. Association between T. cruzi DNA in the peripheral blood and cardiac involvement was not observed.ConclusionCC rates in the studied population are low. Age and sex are important determinants for the development of CC, and with the EKG should guide echocardiogram performance.
Highlights
Patients with abnormal echocardiography were older (47 (IQR 38–57) years vs 41 (IQR 38– 57) years); p = 0.019) and there was a greater proportion of males (66.7% vs 29.7%); p
Chagas disease (CD) is an infection caused by the haemoflagellate protozoan Trypanosoma cruzi
Diagnosis of CD was based on two positive serological enzyme-linked immunosorbent assay (ELISA) tests, one with recombinant antigen (Bioelisa Chagas, Biokit, Lliçà d’Amunt, Spain) and the other with crude antigen (Ortho T. cruzi ELISA, Jonhson & Jonhson, High Wycombe, United Kingdom)
Summary
Chagas disease (CD) is an infection caused by the haemoflagellate protozoan Trypanosoma cruzi. It is a major health issue in Latin America, where the disease is endemic. It affects 8 million people worldwide and 25 million remain at risk.[1] CD causes 10000 casualties every year. Migratory flows have spread the disease worldwide, the majority of cases outside the endemic countries being found in The United States of America and Spain. It is estimated that approximately 43000 migrants infected with T. cruzi are living in Spain.[3]. Chagas disease (CD) is a major cause of cardiomyopathy in Latin America, and migration movements have spread the disease worldwide. Data regarding Chagas cardiomyopathy (CC) and the usefulness of echocardiography in non endemic countries are still scarce
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