{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T10:07:11Z","timestamp":1792663631846,"version":"4.5.0"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2007,3,6]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>Background\u2014<\/jats:italic>\n            <\/jats:bold>\n            Chagas disease is a major cause of morbidity and mortality in Latin America. Knowledge of the predictors of prognosis can help clinical decision making by identifying patients\u2019 level of risk.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Methods and Results\u2014<\/jats:italic>\n            <\/jats:bold>\n            We reviewed the published literature on prognostic factors in patients with Chagas disease by performing a PubMed search for articles published in any language between 1985 and February 2006 and hand searches of the reference lists of retrieved articles. Studies were selected if they included patients in the chronic phase of Chagas disease, analyzed a clearly defined outcome (all-cause mortality, sudden cardiac deaths, and\/or cardiovascular deaths), and used multivariable regression models of prognosis. From 606 potentially relevant studies, 12 met the inclusion criteria: 8 clinic-based studies including 3928 patients and 4 hospital-based studies including 349 patients. Impaired left ventricular function by echocardiogram or cineventriculogram was found to be the most common and consistent independent predictor of death. New York Heart Association functional class III\/IV and cardiomegaly on the chest radiography also were independently associated with higher mortality. More recently, strong evidence was found that nonsustained ventricular tachycardia on 24-hour Holter monitoring indicated an adverse prognosis. The typical ECG abnormalities showed limited additional prognostic value. Other often-mentioned risk factors, advanced age and male sex, showed inconsistent results. A formal meta-analysis was not feasible because of the heterogeneity of published studies and the lack of minimal standards in reporting results.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Conclusions\u2014<\/jats:italic>\n            <\/jats:bold>\n            A systematic review of published studies indicates that impaired left ventricular function, New York Heart Association class III\/IV, cardiomegaly, and nonsustained ventricular tachycardia indicate a poor prognosis in patients with chronic Chagas disease.\n          <\/jats:p>","DOI":"10.1161\/circulationaha.106.627265","type":"journal-article","created":{"date-parts":[[2007,3,5]],"date-time":"2007-03-05T21:58:01Z","timestamp":1173131881000},"page":"1101-1108","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":256,"title":["Predictors of Mortality in Chronic Chagas Disease"],"prefix":"10.1161","volume":"115","author":[{"suffix":"Jr","given":"Anis","family":"Rassi","sequence":"first","affiliation":[{"name":"From the Division of Cardiology, Anis Rassi Hospital, Goia\u0302nia, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anis","family":"Rassi","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Anis Rassi Hospital, Goia\u0302nia, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Se\u0301rgio G.","family":"Rassi","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Anis Rassi Hospital, Goia\u0302nia, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","unstructured":"Control of Chagas\u2019 disease: Second Report of the WHO Expert Committee. Geneva Switzerland: World Health Organization; 2002. Technical Report Series 905."},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1590\/S0066-782X2001000700006"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-2-23"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0167-5273(85)90262-1"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.75.6.3552307"},{"key":"e_1_3_2_6_2","first-page":"465","volume":"56","year":"1991","unstructured":"Guerrero L, Carrasco H, Parada H, Molina C, Chuecos R. Ventricular mechanics and cardiac arrhythmias in patients with chagasic and primary dilated cardiomyopathy: echo-electrocardiographic follow-up [in Spanish]. Arq Bras Cardiol. 1991; 56: 465\u2013469.","journal-title":"Arq Bras Cardiol"},{"key":"e_1_3_2_7_2","first-page":"225","volume":"60","year":"1993","unstructured":"Barretto AC, Arteaga E, Mady C, Ianni BM, Bellotti G, Pileggi F. Male sex: prognostic factor in Chagas\u2019 disease [in Portuguese]. Arq Bras Cardiol. 1993; 60: 225\u2013227.","journal-title":"Arq Bras Cardiol"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.74.3.293"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1590\/S0074-02761999000700060"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1590\/S0037-86821999000600003"},{"key":"e_1_3_2_11_2","first-page":"33","volume":"75","year":"2000","unstructured":"Silva RM, Tavora MZ, Gondim FA, Metha N, Hara VM, Paola AA. Predictive value of clinical and electrophysiological variables in patients with chronic chagasic cardiomyopathy and nonsustained ventricular tachycardia. 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