Change in the Clinical-Demographic Profile of Chagasic Patients Who are Candidates for Heart Transplantation in Recent Years

Abstract

PurposeChagasic cardiomyopathy has an aggressive evolution. When there is an evolution to advanced Heart Failure (HF), Heart Transplant (HT) is the gold standard treatment. In recent years, changes in the clinical-demographic profile of chagasic patients who are candidates for HT have been noticed. This study aims to evaluate this profile of chagasic patients undergoing HT in recent years.MethodsRetrospective observational study in which 313 chagasic patients submitted to TxC from 1/1/2010 to 12/31/2019 were evaluated, divided into 2 groups: A- HT until 12/31/2016; B- HT from 12/1/2017 to 12/31/2019. We evaluated the following pre-TxC characteristics: Age at TxC; genre; age at diagnosis of HF; Arterial hypertension (SAH); diabetes mellitus (DM); Coronary artery disease (CAD); Ejection fraction (EF); LV diastolic diameter (LVDD) and pulmonary hypertension (PH). As for statistical analysis, Student's t-test was used to compare continuous variables and between categorical variables, the chi-square test or Fisher's exact test were used. The value of p <0.05 was defined as statistically significant.ResultsAs seen in Table 1, chagasic candidates for HT in the last 3 years, were older in the diagnosis of HF at HT as well as had more comorbidities, greater LV impairment and more PH with a statistically significant difference between the groups. EF between groups was similar with no significant difference.ConclusionThere was a change in the clinical-demographic profile of Chagas patients who were candidates for HT. However, further studies are needed, especially with parasites to assess whether there has been a change in the virulence profile. Chagasic cardiomyopathy has an aggressive evolution. When there is an evolution to advanced Heart Failure (HF), Heart Transplant (HT) is the gold standard treatment. In recent years, changes in the clinical-demographic profile of chagasic patients who are candidates for HT have been noticed. This study aims to evaluate this profile of chagasic patients undergoing HT in recent years. Retrospective observational study in which 313 chagasic patients submitted to TxC from 1/1/2010 to 12/31/2019 were evaluated, divided into 2 groups: A- HT until 12/31/2016; B- HT from 12/1/2017 to 12/31/2019. We evaluated the following pre-TxC characteristics: Age at TxC; genre; age at diagnosis of HF; Arterial hypertension (SAH); diabetes mellitus (DM); Coronary artery disease (CAD); Ejection fraction (EF); LV diastolic diameter (LVDD) and pulmonary hypertension (PH). As for statistical analysis, Student's t-test was used to compare continuous variables and between categorical variables, the chi-square test or Fisher's exact test were used. The value of p <0.05 was defined as statistically significant. As seen in Table 1, chagasic candidates for HT in the last 3 years, were older in the diagnosis of HF at HT as well as had more comorbidities, greater LV impairment and more PH with a statistically significant difference between the groups. EF between groups was similar with no significant difference. There was a change in the clinical-demographic profile of Chagas patients who were candidates for HT. However, further studies are needed, especially with parasites to assess whether there has been a change in the virulence profile.