Abstract
Tracking of cardiovascular risk factors from childhood to young adulthood — the Pune Children's Study
Highlights
After exploring the clinical characteristics of the patients studied by Bestetti et al [1], it was found that data related to a higher risk for malignant arrhythmias were more present in the chagasic group than in the hypertensive group, such as the occurrence of ventricular premature complexes (46% versus 18%, p b 0.005), and the necessity for the use of amiodarone (39% versus 19%, p b 0.005) and of an implanted cardioverter-defibrillator (16% versus 0.7%, p b 0.001), despite a similar left ventricular ejection fraction (35% ± 13% versus 36% ± 10%, ns)
I do believe that the main reason for the poorer outcome in patients with CHF due to Chagas heart disease, in comparison to those with CHF secondary to hypertensive cardiomyopathy and similar left ventricular ejection fractions, is the occurrence of malignant ventricular arrhythmias leading to SCD in chagasic patients
Studies from high-income countries have reported tracking of individual risk factors from childhood to adulthood [1–7]; there are no reports of child–adult tracking in low- and middle-income countries (LMICs)
Summary
After exploring the clinical characteristics of the patients studied by Bestetti et al [1], it was found that data related to a higher risk for malignant arrhythmias were more present in the chagasic group than in the hypertensive group, such as the occurrence of ventricular premature complexes (46% versus 18%, p b 0.005), and the necessity for the use of amiodarone (39% versus 19%, p b 0.005) and of an implanted cardioverter-defibrillator (16% versus 0.7%, p b 0.001), despite a similar left ventricular ejection fraction (35% ± 13% versus 36% ± 10%, ns). Studies from high-income countries have reported tracking of individual risk factors from childhood to adulthood [1–7]; there are no reports of child–adult tracking in low- and middle-income countries (LMICs). We measured a range of CVD risk factors at 8 [8] (1996–7) and 21 (2009–11) years of age, using similar methods, providing the first opportunity to assess child–adult tracking in a LMIC.
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