Abstract
Patients with Chagas cardiomyopathy (ChC) usually progress with fatigue and dyspnea. Exercise tests are valuable for the functional evaluation of these patients. However, information about the applicability of the exercise tests is scattered, and no studies have systematically reviewed the results. Thus, the present review explored the general aspects and prognostic value of exercise tests in patients with ChC. A literature search of the MEDLINE, Web of Science, CINAHL, Scopus, and LILACS databases was performed to identify relevant studies. There were no data restrictions, and articles that met the objective of the study were selected. Articles written in English, Portuguese, and Spanish were considered, and 25 articles were finally included. The peak oxygen uptake (VO2peak) was correlated with demographic and echocardiographic variables. Echocardiographic features of the left ventricular diastolic function and right ventricular systolic function appeared to be determinants of functional capacity, in addition to age and sex. VO2peak was associated with higher mortality, especially in patients with dilated ChC. The minute ventilation/carbon dioxide production slope (VE/VCO2 slope) was a strong predictor of survival; however, more studies are needed to verify this observation. Field tests showed moderate to strong correlation with VO2peak and thus may be inexpensive tools for the functional evaluation of patients with ChC. However, few studies have verified their prognostic significance. While exercise tests are useful tools for functional assessment, information is scarce regarding further considerations, and many of the criteria are based on guidelines for other heart diseases.
Highlights
Chagas disease remains a serious public health problem
Costa HS et al - Exercise tests in Chagas cardiomyopathy
This review explored the applicability of exercise tests in patients with Chagas cardiomyopathy (ChC), highlighting their general aspects, determinants, and prognostic value, as well as the challenges faced
Summary
Chagas disease remains a serious public health problem. While the incidence and prevalence are decreasing dramatically, 6 million people are infected in Latin America and more than 70 million are at a risk of infection[1]. In Brazil, Chagas disease is a major cause of morbidity and mortality among tropical diseases and www.scielo.br/rsbmt I www.rsbmt.org.br. Costa HS et al - Exercise tests in Chagas cardiomyopathy. Non-invasive methods such as conventional maximal exercise test and cardiopulmonary exercise testing (CPET) can detect significant changes, including exerciseinduced ventricular arrhythmias (EIVAs)[8] and chronotropic incompetence[9]. The usefulness of exercise tests in ChC has not been systematically discussed. This review explored the applicability of exercise tests in patients with ChC, highlighting their general aspects, determinants, and prognostic value, as well as the challenges faced
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