Prognostic factors associated with progression and mortality in adults with chronic Chagas cardiomyopathy: A systematic review and meta-analysis
DOI:
https://doi.org/10.5281/zenodo.21544057Keywords:
Chagas disease, Chagas cardiomyopathy, prognosis, left ventricular ejection fraction, mortalityAbstract
Introduction: Chronic Chagas cardiomyopathy (CCC) is one of the leading causes of heart failure and cardiovascular mortality in Latin America. Identifying factors that predict its progression is crucial for clinical management.
Objective: To identify and quantify prognostic factors associated with mortality and disease progression in adults with CCC.
Methods: A systematic review was conducted following the PRISMA statement in PubMed, SciELO and ScienceDirect (2006–2025). Cohort studies evaluating clinical, echocardiographic and biomarker predictors were included. A fixed-effects meta-analysis was performed for left ventricular ejection fraction (LVEF) < 45% and mortality.
Results: Twelve studies were included (total n > 8,000 patients). LVEF < 45% was the most consistent predictor of mortality (HR 2.61; 95% CI 1.98–3.14; I2 = 0%). Other relevant predictors included reduced global longitudinal strain (GLS), elevated NT-proBNP levels and the presence of complex ventricular arrhythmias.
Conclusion: Left ventricular systolic dysfunction remains the central prognostic marker, although functional parameters such as GLS and biochemical biomarkers allow more precise risk stratification.
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Copyright (c) 2026 Ludmila Ebia Dos Santos Bineck, Maisa De Lima Correia Silva, Kamila De Almeida Silva, Jennifer Akina Murakami Yamaguchi, Isadora Damasceno Lobato, Bárbara Lorrayne Da Silva Motta, Adelma Luiza Dos Santos Porto, Diane Ellen Damasceno Queiroz, Sarah Eduarda Pinheiro De Paula, Andrea Paola Britos Gómez (Autor/a)
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