CLINICAL COURSE OF CHAGAS HEART-DISEASE - A COMPARISON WITH DILATED CARDIOMYOPATHY

This investigation was carried out to compare the clinical course of p atients with chronic Chagas' heart disease with that of patients with dilated cardiomyopathy. A total of 125 patients (75 chagasic and 50 no nchagasic) prospectively followed up at the Cardiomyopathy clinic of S anta Casa Hospital from January 1990 to June 1993 entered the study. P atients underwent clinical history, physical examination, serological tests, resting electrocardiogram, chest X-ray and two-dimensional echo cardiography. In nonchagasic patients, hypertensive cardiomyopathy was found in 17 of 50 (34%) patients, idiopathic dilated cardiomyopathy i n 16 (32%), the association of hypertension and coronary artery diseas e in 12 (24%) and ischemic cardiomyopathy in two (4%). Twenty-one (23% ) chagasic and three (6%) nonchagasic patients died during the study p eriod (P = 0.02). Sudden cardiac death occurred in eight (38%) chagasi c patients, pump failure death was detected in 10 (47%) and the mode o f death could not be determined in three (14%) patients with chronic C hagas' heart disease. Thus, patients with chronic Chagas' heart diseas e have a clinical course worse than that of patients with nonchagasic dilated cardiomyopathy. This bet may be ascribed to the electrocardiog raphic and morphological peculiarities usually found in chronic Chagas ' heart disease. (C) 1997 Elsevier Science Ireland Ltd.