{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T13:31:22Z","timestamp":1769088682935,"version":"3.49.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":1767,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T00:00:00Z","timestamp":1613520000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aimed to analyse the clinical presentation and prognosis of patients with Chagas cardiomyopathy and decompensated heart failure (HF), as compared with other aetiologies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>A prospective cohort of patients admitted with decompensated HF. We included 767 patients (63.9% male), with median age of 58 years [interquartile range 48.2\u201366.7 years]. Main aetiologies were non-Chagas\/non-ischaemic cardiomyopathies in 389 (50.7%) patients, ischaemic disease in 209 (27.2%), and Chagas disease in 169 (22%). Median left ventricular ejection fraction was 26% (interquartile range 22\u201335%). Patients with Chagas differed from both patients with non-Chagas\/non-ischaemic and ischaemic cardiomyopathies for a higher proportion of cardiogenic shock at admission (17.8%, 11.6%, and 11%, respectively, P &amp;lt; 0.001) and had lower blood pressure at admission (systolic blood pressure 90 [80\u2013102.5], 100 [85\u2013110], and 100 [88.2\u2013120] mmHg, P &amp;lt; 0.001) and lower heart rate (heart rate 71 [60\u201380], 87 [70\u2013102], and 79 [64\u201396.5] b.p.m., P &amp;lt; 0.001). Further, patients with Chagas had higher serum BNP level (1544 [734\u20133148], 1061 [465\u2013239], and 927 [369\u20131455] pg\/mL, P &amp;lt; 0.001), higher serum bilirubin (1.4 [0.922.44], 1.2 [0.77\u20132.19], and 0.84 [0.49\u20131.45] mg\/dL, P &amp;lt; 0.001), larger left ventricular diameter (68 [63\u201373], 67 [58\u201374], and 62 [56.8\u201368.3] mm, respectively, P &amp;lt; 0.001), lower left ventricular ejection fraction (25 [21\u201330]%, 26 [22\u201335]%, and 30 [25\u201338]%, P &amp;lt; 0.001), and a higher proportion of patients with right ventricular function (48.8%, 40.7%, and 25.9%, P &amp;lt; 0.001). Patients with Chagas disease were more likely to receive inotropes than patients with non-Chagas\/non-ischaemic and ischaemic cardiomyopathies (77.5%, 67.5%, and 62.5%, respectively, P = 0.007) and also to receive intra-aortic balloon pumping (30.8%, 16.2%, and 10.5%, P &amp;lt; 0.001). Overall, the rates of death or urgent transplant were higher among patients with Chagas than in other aetiologies, a difference that was driven mostly due to increased rate of heart transplant during hospital admission (20.2%, 10.3%, and 8.1%). The prognosis of patients at 180 days after hospital admission was worse for patients with Chagas disease as compared with other aetiologies. In patients with Chagas, age [odds ratio (OR) = 0.934, confidence interval (CI)95% 0.901\u20130.982, P = 0.005], right ventricular dysfunction by echocardiography (OR = 2.68, CI95% 1.055\u20136.81, P = 0.016), and urea (OR = 1.009, CI95% 1.001\u20131.018, P = 0.038) were significantly associated with prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with Chagas cardiomyopathy and decompensated HF have a distinct clinical presentation and worse prognosis compared with other aetiologies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13232","type":"journal-article","created":{"date-parts":[[2021,2,20]],"date-time":"2021-02-20T08:23:09Z","timestamp":1613809389000},"page":"1460-1471","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The Course of Patients with Chagas Heart Disease During Episodes of Decompensated Heart Failure"],"prefix":"10.1093","volume":"8","author":[{"given":"Victor Sarli","family":"Issa","sequence":"first","affiliation":[{"name":"Department of Cardiology, Antwerp University Hospital , Wilrijkstraat 10, Edegem, 2650 ,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia Moreira","family":"Ayub-Ferreira","sequence":"additional","affiliation":[{"name":"Heart Institute (InCor) do Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo ,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Schroyens","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Antwerp University Hospital , Wilrijkstraat 10, Edegem, 2650 ,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulo Roberto","family":"Chizzola","sequence":"additional","affiliation":[{"name":"Heart Institute (InCor) do Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo ,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulo Rogerio","family":"Soares","sequence":"additional","affiliation":[{"name":"Heart Institute (InCor) do Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo ,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia Helena Gelas","family":"Lage","sequence":"additional","affiliation":[{"name":"Heart Institute (InCor) do Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo ,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edimar Alcides","family":"Bocchi","sequence":"additional","affiliation":[{"name":"Heart Institute (InCor) do 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