Electrocardiographic Abnormalities in Trypanosoma cruzi Seropositive and Seronegative Former Blood Donors

Background: 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.

URI

https://observatorio.fm.usp.br/handle/OPI/1971

Referências

ARTEAGA-FERNANDEZ E, 1985, Arquivos Brasileiros de Cardiologia, V44, P333
Bern C, 2009, CLIN INFECT DIS, V49, pE52, DOI 10.1086/605091
Biolo A, 2010, PROG CARDIOVASC DIS, V52, P300, DOI 10.1016/j.pcad.2009.11.008
CASADO J, 1990, INT J CARDIOL, V27, P55, DOI 10.1016/0167-5273(90)90191-7
de Bruyne MC, 1999, AM J EPIDEMIOL, V150, P1282
Dekker JM, 1997, AM J EPIDEMIOL, V145, P899
Denes P, 2007, JAMA-J AM MED ASSOC, V297, P978, DOI 10.1001/jama.297.9.978
DIAS J C P, 1968, Revista do Instituto de Medicina Tropical de Sao Paulo, V10, P158
Dias JCP, 2007, MEM I OSWALDO CRUZ, V102, P11, DOI 10.1590/S0074-02762007005000092
ESPINOSA RA, 1991, INT J CARDIOL, V30, P195, DOI 10.1016/0167-5273(91)90095-7
Garzon S A, 1995, Sao Paulo Med J, V113, P802
GASCON J, 2009, ACTA TROP, V115, P22, DOI 10.1016/J.ACTATROPICA.2009.07.019
Goncalves JGF, 2011, REV SOC BRAS MED TRO, V44, P40, DOI 10.1590/S0037-86822011000800007
Guerrero L, 1991, Arq Bras Cardiol, V56, P465
Hamilton RM, 2004, INT J CARDIOL, V95, P109, DOI 10.1016/j.ijcard.2003.07.002
JUNQUEIRA LF, 1990, BRAZ J MED BIOL RES, V23, P1091
Junqueira LF, 2012, REV SOC BRAS MED TRO, V45, P243, DOI 10.1590/S0037-86822012000200020
Lang RM, 2005, J AM SOC ECHOCARDIOG, V18, P1440, DOI 10.1016/j.echo.2005.10.005
Lima-Costa MF, 2010, INT J CARDIOL, V145, P362, DOI 10.1016/j.ijcard.2010.02.036
Macfarlane PW, 2007, J ELECTROCARDIOL, V40, P101, DOI 10.1016/j.jelectrocard.2006.05.003
Williams-Blangero S, 2007, AM J TROP MED HYG, V77, P495
MAGUIRE JH, 1987, CIRCULATION, V75, P1140
MAGUIRE JH, 1983, AM HEART J, V105, P287, DOI 10.1016/0002-8703(83)90529-X
Nascimento BR, 2012, J ELECTROCARDIOL, V45, P43, DOI [10.1016/j.jelectrocard.2011.04.011, 10.1016/j.jelectrocard.2011.04.01]
PORTO CELMO CELENO, 1964, ARQ BRASIL CARDIOL, V17, P313
Prineas RJ, 1982, MINNESOTA CODE MANUA
Rautaharju PM, 2004, AM J CARDIOL, V93, P1017, DOI 10.1016/j.amjcard.2003.12.055
Ribeiro AL, 2012, NAT REV CARDIOL, V9, P576, DOI 10.1038/nrcardio.2012.109
Ribeiro ALP, 2001, AM HEART J, V141, P260, DOI 10.1067/mhj.2001.111406
Ribeiro ALP, 2005, INT J CARDIOL, V103, P225, DOI 10.1016/j.ijcard.2004.11.007
Ribeiro ALP, 2008, J CARDIOVASC ELECTR, V19, pE41, DOI 10.1111/j.1540-8167.2008.01173.x
Ribeiro ALP, 2006, INT J CARDIOL, V109, P34, DOI 10.1016/j.ijcard.2005.05.048
Ribeiro ALP, 2000, PACE, V23, P2014
Rincon LG, 2006, REV SOC BRAS MED TRO, V39, P245, DOI 10.1590/S0037-86822006000300003
Rocha MOC, 2009, MEM I OSWALDO CRUZ, V104, P159, DOI 10.1590/S0074-02762009000900022
Rodriguez-Salas LA, 1998, ECHOCARDIOGR-J CARD, V15, P271, DOI 10.1111/j.1540-8175.1998.tb00607.x
Sabino EC, 2013, TRANSFUSION, V53, P1257, DOI 10.1111/j.1537-2995.2012.03902.x
Sabino EC, 2013, CIRCULATION IN PRESS
Sabino EC, 2010, TRANSFUSION, V50, P2628, DOI 10.1111/j.1537-2995.2010.02756.x
Salles G, 2003, CIRCULATION, V108, P305, DOI 10.1161/01.CIR.00000749174.13444.9C
Salles GF, 2004, AM J CARDIOL, V93, P1136, DOI 10.1016/j.amjcard.2004.01.040
Salles GF, 2003, PACE, V26, P1326, DOI 10.1046/j.1460-9592.2003.t01-1-00190.x
Salles NA, 1996, TRANSFUSION, V36, P969, DOI 10.1046/j.1537-2995.1996.36111297091740.x
Salvatella R, 2007, MEM I OSWALDO CRUZ, V102, P39, DOI 10.1590/S0074-02762007005000105
Valerio L, 2011, EURO SURVEILL, V16
Villar JC, 2004, INT J CARDIOL, V93, P189, DOI 10.1016/j.ijcard.2003.03.002
World Health Organization, 2010, WHOHTMNTDIDM20101
World Health Organization, 2010, 1 M LEPT BURD EP REF, P1
Zaniello BA, 2012, PLOS NEGLECT TROP D, V6, DOI 10.1371/journal.pntd.0001771

Coleções

Artigos e Materiais de Revistas Científicas - FM/MIP
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/11
Artigos e Materiais de Revistas Científicas - LIM/46
Artigos e Materiais de Revistas Científicas - LIM/52

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