Electrocardiographic Abnormalities in Trypanosoma cruzi Seropositive and Seronegative Former Blood Donors

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorRIBEIRO, Antonio L.
dc.contributor.authorSABINO, Ester C.
dc.contributor.authorMARCOLINO, Milena S.
dc.contributor.authorSALEMI, Vera M. C.
dc.contributor.authorIANNI, Barbara M.
dc.contributor.authorFERNANDES, Fabio
dc.contributor.authorNASTARI, Luciano
dc.contributor.authorANTUNES, Andre
dc.contributor.authorMENEZES, Marcia
dc.contributor.authorOLIVEIRA, Claudia Di Lorenzo
dc.contributor.authorSACHDEV, Vandana
dc.contributor.authorCARRICK, Danielle M.
dc.contributor.authorBUSCH, Michael P.
dc.contributor.authorMURPHY, Eduard L.
dc.contributor.groupauthorNHLBI Retrovirus Epidemiology
dc.date.accessioned2013-09-23T16:39:43Z
dc.date.available2013-09-23T16:39:43Z
dc.date.issued2013
dc.description.abstractBackground: Blood donor screening leads to large numbers of new diagnoses of Trypanosoma cruzi infection, with most donors in the asymptomatic chronic indeterminate form. Information on electrocardiogram (ECG) findings in infected blood donors is lacking and may help in counseling and recognizing those with more severe disease. Objectives: To assess the frequency of ECG abnormalities in T. cruzi seropositive relative to seronegative blood donors, and to recognize ECG abnormalities associated with left ventricular dysfunction. Methods: The study retrospectively enrolled 499 seropositive blood donors in Sao Paulo and Montes Claros, Brazil, and 483 seronegative control donors matched by site, gender, age, and year of blood donation. All subjects underwent a health clinical evaluation, ECG, and echocardiogram (Echo). ECG and Echo were reviewed blindly by centralized reading centers. Left ventricular (LV) dysfunction was defined as LV ejection fraction (EF), 0.50%. Results: Right bundle branch block and left anterior fascicular block, isolated or in association, were more frequently found in seropositive cases (p<0.0001). Both QRS and QTc duration were associated with LVEF values (correlation coefficients -0.159, p<0.0003, and -0.142, p = 0.002) and showed a moderate accuracy in the detection of reduced LVEF (area under the ROC curve: 0.778 and 0.790, both p<0.0001). Several ECG abnormalities were more commonly found in seropositive donors with depressed LVEF, including rhythm disorders (frequent supraventricular ectopic beats, atrial fibrillation or flutter and pacemaker), intraventricular blocks (right bundle branch block and left anterior fascicular block) and ischemic abnormalities (possible old myocardial infarction and major and minor ST abnormalities). ECG was sensitive (92%) for recognition of seropositive donors with depressed LVEF and had a high negative predictive value (99%) for ruling out LV dysfunction. Conclusions: ECG abnormalities are more frequent in seropositive than in seronegative blood donors. Several ECG abnormalities may help the recognition of seropositive cases with reduced LVEF who warrant careful follow-up and treatment.
dc.description.indexMEDLINE
dc.description.sponsorshipNIH/NHLBI [HHSN268201100007I]
dc.identifier.citationPLOS NEGLECTED TROPICAL DISEASES, v.7, n.2, article ID e2078, 8p, 2013
dc.identifier.doi10.1371/journal.pntd.0002078
dc.identifier.issn1935-2735
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/1971
dc.language.isoeng
dc.publisherPUBLIC LIBRARY SCIENCE
dc.relation.ispartofPlos Neglected Tropical Diseases
dc.rightsrestrictedAccess
dc.rights.holderCopyright PUBLIC LIBRARY SCIENCE
dc.subject.otherchronic chagas-disease
dc.subject.otherventricular systolic dysfunction
dc.subject.otherheart-rate-variability
dc.subject.otherrisk stratification
dc.subject.otherautonomic function
dc.subject.otherfollow-up
dc.subject.othermortality
dc.subject.otherpopulation
dc.subject.otherbrazil
dc.subject.othercardiomyopathy
dc.subject.wosInfectious Diseases
dc.subject.wosParasitology
dc.subject.wosTropical Medicine
dc.titleElectrocardiographic Abnormalities in Trypanosoma cruzi Seropositive and Seronegative Former Blood Donors
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.affiliation.countryEstados Unidos
hcfmusp.affiliation.countryisous
hcfmusp.author.externalRIBEIRO, Antonio L.:Univ Fed Minas Gerais, Hosp Clin, Belo Horizonte, MG, Brazil; Univ Fed Minas Gerais, Fac Med, Belo Horizonte, MG, Brazil
hcfmusp.author.externalMARCOLINO, Milena S.:Univ Fed Minas Gerais, Hosp Clin, Belo Horizonte, MG, Brazil; Univ Fed Minas Gerais, Fac Med, Belo Horizonte, MG, Brazil
hcfmusp.author.externalANTUNES, Andre:Univ Estadual Montes Claros, Ctr Ciencias Biol & Saude, Montes Claros, Brazil
hcfmusp.author.externalMENEZES, Marcia:Univ Estadual Montes Claros, Ctr Ciencias Biol & Saude, Montes Claros, Brazil
hcfmusp.author.externalOLIVEIRA, Claudia Di Lorenzo:Univ Fed Sao Joao del Rei, Divinopolis, Brazil
hcfmusp.author.externalSACHDEV, Vandana:NHLBI, Bethesda, MD 20892 USA
hcfmusp.author.externalCARRICK, Danielle M.:WESTAT Corp, Rockville, MD 20850 USA
hcfmusp.author.externalBUSCH, Michael P.:Blood Syst Res Inst, San Francisco, CA USA; Univ Calif San Francisco, San Francisco, CA 94143 USA
hcfmusp.author.externalMURPHY, Eduard L.:Blood Syst Res Inst, San Francisco, CA USA; Univ Calif San Francisco, San Francisco, CA 94143 USA
hcfmusp.citation.scopus50
hcfmusp.contributor.author-fmusphcESTER CERDEIRA SABINO
hcfmusp.contributor.author-fmusphcVERA MARIA CURY SALEMI
hcfmusp.contributor.author-fmusphcBARBARA MARIA IANNI
hcfmusp.contributor.author-fmusphcFABIO FERNANDES
hcfmusp.contributor.author-fmusphcLUCIANO NASTARI
hcfmusp.description.articlenumbere2078
hcfmusp.description.issue2
hcfmusp.description.volume7
hcfmusp.origemWOS
hcfmusp.origem.pubmed23469305
hcfmusp.origem.scopus2-s2.0-84874768210
hcfmusp.origem.wosWOS:000315644900042
hcfmusp.publisher.citySAN FRANCISCO
hcfmusp.publisher.countryUSA
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hcfmusp.remissive.sponsorshipNIH
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