{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:20:03Z","timestamp":1787314803848,"version":"build-2736575974"},"reference-count":57,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,6,20]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Chagas disease (CD) presents an ominous prognosis. The predictive value of biomarkers and new echocardiogram parameters in adjusted models have not been well studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      There were 361 patients with chronic CD (57.6% men, 61\u00b111\u2009years of age, clinical forms: indeterminate 27.1%, cardiac 56.6%, digestive 3.6%, cardiodigestive 12.7%) included in this single\u2010center, observational, prospective longitudinal study. Echocardiographic evaluation included strain analyses of left atrial, left ventricular (LV), and right ventricular and 3\u2010dimensional analyses of left atrial and LV volumes. Biomarkers included cardiac troponin I, brain natriuretic peptide, transforming growth factor \u03b21, tumor necrosis factor, matrix metalloproteinases, and\n                      <jats:italic>Trypanosoma cruzi<\/jats:italic>\n                      polymerase chain reaction. The studied end point was a composite of CD\u2010related mortality, heart transplant, hospital admission due to worsening heart failure, or new cardiac device insertion. Event\u2010free survival was analyzed by multivariable regression analyses adjusted for competing risks.\n                      <jats:italic>P<\/jats:italic>\n                      values &lt;0.05 were considered significant. The composite event occurred in 79 patients after 4.9\u00b12.0\u2009years follow\u2010up. LV end\u2010diastolic volume (hazard ratio [HR], 1.01 [95% CI, 1.00\u20131.02];\n                      <jats:italic>P<\/jats:italic>\n                      =0.02), peak negative global atrial strain (HR, 1.08 [95% CI, 1.00\u20131.17];\n                      <jats:italic>P<\/jats:italic>\n                      =0.04), LV global circumferential strain (HR, 1.12 [95% CI, 1.04\u20131.21];\n                      <jats:italic>P<\/jats:italic>\n                      =0.003), LV torsion (HR, 0.55 [95% CI, 0.35\u20130.81];\n                      <jats:italic>P<\/jats:italic>\n                      =0.003), brain natriuretic peptide (HR, 2.03 [95% CI, 1.23\u20133.34];\n                      <jats:italic>P<\/jats:italic>\n                      =0.005), and positive\n                      <jats:italic>T cruzi<\/jats:italic>\n                      polymerase chain reaction (HR, 1.80 [95% CI, 1.12\u20132.91];\n                      <jats:italic>P<\/jats:italic>\n                      =0.01) were end point predictors independent from age, sex, 2\u2010dimensional echocardiographic indexes, hypertension, previous cardiac device, and CD cardiac form.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Two\u2010dimensional strain\u2010 and 3\u2010dimensional\u2010derived parameters, brain natriuretic peptide, and positive\n                      <jats:italic>T cruzi<\/jats:italic>\n                      polymerase chain reaction can be useful for prediction of CD cardiovascular events.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.122.028810","type":"journal-article","created":{"date-parts":[[2023,6,14]],"date-time":"2023-06-14T06:28:27Z","timestamp":1686724107000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Biomarkers and Echocardiographic Predictors of Cardiovascular Outcome in Patients With Chronic Chagas Disease"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2712-1833","authenticated-orcid":false,"given":"Veronica G.","family":"Mendes","sequence":"first","affiliation":[{"name":"Clinical Research Laboratory in Chagas Disease Evandro Chagas National Institute of Infectious Diseases Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5149-0503","authenticated-orcid":false,"given":"Lorena","family":"Rimolo","sequence":"additional","affiliation":[{"name":"Antonio Pedro University Hospital Fluminense Federal University Niter\u00f3i Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6705-4415","authenticated-orcid":false,"given":"Ana Carolina B.","family":"de Lima","sequence":"additional","affiliation":[{"name":"Molecular Biology and Endemic Diseases Laboratory Oswaldo Cruz Institute Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5010-7007","authenticated-orcid":false,"given":"Roberto R.","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Laboratory of Applied Genomics and Bioinnovations Oswaldo Cruz Institute Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciano S.","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Clinical Research Laboratory in Chagas Disease Evandro Chagas National Institute of Infectious Diseases Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7136-9532","authenticated-orcid":false,"given":"Lindice M.","family":"Nisimura","sequence":"additional","affiliation":[{"name":"Laboratory of Innovations in Therapies, Education and Bioproducts Oswaldo Cruz Institute Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2800-4746","authenticated-orcid":false,"given":"Samuel I. 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