Back to Search
Start Over
Stroke history and Chagas disease are independent predictors of silent cerebral microembolism in patients with congestive heart failure.
- Source :
-
Cerebrovascular diseases (Basel, Switzerland) [Cerebrovasc Dis] 2011; Vol. 31 (1), pp. 19-23. Date of Electronic Publication: 2010 Oct 28. - Publication Year :
- 2011
-
Abstract
- Background: Chagas disease is endemic in South and Central America, where 18 million individuals are infected by Trypanosoma cruzi, causing congestive heart failure (CHF) and cardioembolic stroke. Transcranial Doppler (TCD) is able to detect real-time microembolic signals (MES) to the brain vessels and may represent a surrogate marker of stroke risk. We aimed to determine predictors of MES in a population of patients with CHF.<br />Methods: Consecutive CHF patients from a university-based cardiomyopathy clinic underwent TCD recording of the middle cerebral artery for 60 min by a single investigator who was blinded to all clinical data including cardiomyopathy etiology. Predictors of MES were sought by multivariable logistic regression analysis.<br />Results: From April 2004 to February 2009, 144 patients were studied, including 62 (44.6%) patients with Chagas disease. MES were detected in 9 (6.2%) patients and were more frequent in patients with Chagas disease than in patients with other causes of CHF (12.9 vs. 1.2%, p = 0.005). In multivariate analysis corrected for age and left-ventricular ejection fraction, predictors of MES were Chagas disease (odds ratio = 1.15, 95% confidence interval = 1.05-1.26, p = 0.004) and stroke history (odds ratio = 1.27, 95% confidence interval = 1.08-1.50, p = 0.005).<br />Conclusions: Chagas disease and stroke history are risk factors for MES independent of cardiac disease severity. Other mechanisms besides structural cardiac disease may be operative, increasing embolic risk in Chagas disease.<br /> (Copyright © 2010 S. Karger AG, Basel.)
- Subjects :
- Adult
Aged
Brazil
Cerebrovascular Circulation
Female
Hospitals, University
Humans
Intracranial Embolism diagnostic imaging
Intracranial Embolism physiopathology
Logistic Models
Male
Middle Aged
Odds Ratio
Risk Assessment
Risk Factors
Stroke diagnostic imaging
Stroke physiopathology
Ultrasonography, Doppler, Transcranial
Chagas Cardiomyopathy etiology
Chagas Disease complications
Heart Failure etiology
Intracranial Embolism etiology
Middle Cerebral Artery diagnostic imaging
Middle Cerebral Artery physiopathology
Stroke etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1421-9786
- Volume :
- 31
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Cerebrovascular diseases (Basel, Switzerland)
- Publication Type :
- Academic Journal
- Accession number :
- 20980749
- Full Text :
- https://doi.org/10.1159/000319892