{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:27:14Z","timestamp":1787506034222,"version":"build-2736575974"},"update-to":[{"DOI":"10.1371\/journal.pntd.0012941","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000}}],"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001807","name":"Funda\u00c3\u00a7\u00c3\u00a3o de Amparo \u00c3\u00a0 Pesquisa do Estado de S\u00c3\u00a3o Paulo","doi-asserted-by":"publisher","award":["2015\/24319-1"],"award-info":[{"award-number":["2015\/24319-1"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Funda\u00c3\u00a7\u00c3\u00a3o para Apoio a Pesquisa do Estado de S\u00c3\u00a3o Paulo","award":["2016\/25403-9"],"award-info":[{"award-number":["2016\/25403-9"]}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Chronic Chagas cardiomyopathy (CCC) is associated with a high incidence of cardiovascular events. Global longitudinal strain (GLS) is useful in predicting adverse cardiovascular outcomes in several cardiomyopathies. However, its prognostic value in CCC is not well established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was a retrospective echocardiography analysis with prospective follow-up of CCC subjects. GLS was defined as the average of three apical peak longitudinal strain measurements of the LV using vendor-independent software. GLS groups were defined according to tertiles: (1) GLS\u2009\u2264\u2009-18.4%, (2) GLS\u2009&gt;\u2009-18.4% and &lt;-13.8%, and (3) GLS\u2009\u2265\u2009-13.8%. The primary outcome was a composite of death, hospitalization, sustained ventricular tachycardia (SVT), new heart failure, any systemic embolism, hospitalization, reverted cardiac arrest and cardiac heart transplantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>GLS was obtained in 77 subjects, 50.6% were males and the mean age was 56\u2009\u00b1\u200915 years. There were 6.49% losses of follow-up and the mean LVEF was 51\u2009\u00b1\u200914%. After a follow-up period of 35\u2009\u00b1\u200919 months (2.9 y), 33 subjects reached the composite outcome. Death and hospitalization were the most frequent outcomes (n\u2009=\u20099), followed by new heart failure (n\u2009=\u20096), embolism (n\u2009=\u20096), and SVT (n\u2009=\u20093). The GLS\u2009\u2265\u2009-13.8% was associated with a worse prognosis when compared with the other tertile GLS groups (log rank-p-value\u2009=\u20090.001 for both comparisons). On the multivariate Cox proportional hazard model, adjusting for age, gender, and LVEF, GLS was an independent predictor of outcomes with an HR of 1.20 (CI\u2009=\u20091.05-1.38;p\u2009=\u20090.008).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Left ventricle GLS is an independent predictor of cardiovascular outcomes in patients with CCC. GLS may be an important tool for Chagas disease risk stratification, independent of LVEF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0012941","type":"journal-article","created":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T17:43:09Z","timestamp":1754502189000},"page":"e0012941","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Global longitudinal strain as a predictor of outcomes in chronic Chagas\u00b4 cardiomyopathy"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8742-3764","authenticated-orcid":true,"given":"Minna Moreira Dias","family":"Romano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrique Turin","family":"Moreira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fawaz","family":"Alenezi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Kisslo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernardo","family":"Lombo Lievano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedito Carlos","family":"Maciel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Ant\u00f4nio","family":"Marin-Neto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric J.","family":"Velazquez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,8,6]]},"reference":[{"issue":"8","key":"pntd.0012941.ref001","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1056\/NEJMoa053241","article-title":"Development and validation of a risk score for predicting death in Chagas\u2019 heart disease","volume":"355","author":"A Rassi","year":"2006","journal-title":"N Engl J Med"},{"key":"pntd.0012941.ref002","first-page":"18","article-title":"Chagas heart disease.","volume-title":"Evidence-Based Cardiology","author":"JA Marin-Neto","year":"2010"},{"issue":"9723","key":"pntd.0012941.ref003","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1016\/S0140-6736(10)60061-X","article-title":"Chagas disease","volume":"375","author":"A Rassi","year":"2010","journal-title":"Lancet"},{"issue":"6","key":"pntd.0012941.ref004","article-title":"The art of risk stratification in Chagas\u2019 disease","volume":"19","author":"A Rassi","year":"2008","journal-title":"J Cardiovasc Electrophysiol"},{"issue":"24","key":"pntd.0012941.ref005","doi-asserted-by":"crossref","first-page":"3738","DOI":"10.1161\/CIRCULATIONAHA.105.561423","article-title":"Influence of ejection fraction on cardiovascular outcomes in a broad spectrum of heart failure patients","volume":"112","author":"SD Solomon","year":"2005","journal-title":"Circulation"},{"issue":"5","key":"pntd.0012941.ref006","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1016\/S0735-1097(00)00511-8","article-title":"Echocardiographic predictors of clinical outcome in patients with left ventricular dysfunction enrolled in the SOLVD registry and trials: significance of left ventricular hypertrophy. 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