Left ventricular (LV) systolic dysfunction is a major prognostic determinan
t in Chagas' disease (ChD), a potentially fatal disorder which affects near
ly 20 million individuals in Latin America. Therefore, reliable screening m
ethods are needed to identify patients in need of a detailed evaluation of
LV function. Since previous reports have suggested that a prolonged QRS dur
ation may be an accurate predictor of LV dysfunction, the relationship betw
een QRS duration and LV function was evaluated in ChD patients, in order to
determine whether a narrow QRS on surface electrocardiogram (ECG) predicts
a normal LV function. Ninety-eight patients with ChD and no other cardiac
or systemic illness were underwent standard 12-lead ECG and Doppler echocar
diogram (echo) examination. An investigator (blinded to the echo data) meas
ured manually the QRS duration. LV dysfunction was defined by the presence
of LV dilatation (LV diastolic dimension > 55 mm), depressed LV ejection fr
action (LVEF < 0.50), segmental contractile abnormalities (SCA) or LV aneur
ysm. QRS duration was significantly correlated with LV diastolic dimension
(r = 0.44, P = 0.000) and LVEF (r = 0.24, P = 0.016). A significant percent
age of patients with QRS < 100 ms had abnormal systolic LV parameters, incl
uding LV dilatation (8.1%), reduced EF (10.2%), SCA (42.8%) and LV aneurysm
(14.2%). A narrow QRS does not exclude the presence of significant global
and segmental LV dysfunction in ChD patients. Since these abnormalities hav
e prognostic and therapeutic implications, further evaluation of LV systoli
c performance is desirable in such patients.