1. Electrocardiographic abnormalities in Trypanosoma cruzi seropositive and seronegative former blood donors
- Author
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Antonio L Ribeiro, Ester C Sabino, Milena S Marcolino, Vera M C Salemi, Barbara M Ianni, Fábio Fernandes, Luciano Nastari, André Antunes, Márcia Menezes, Cláudia Di Lorenzo Oliveira, Vandana Sachdev, Danielle M Carrick, Michael P Busch, Eduard L Murphy, NHLBI Retrovirus Epidemiology Donor Study-II (REDS-II), International Component, and Debrabant, Alain
- Subjects
Chagas Cardiomyopathy ,Male ,Antibodies, Protozoan ,Blood Donors ,Cardiovascular ,Medical and Health Sciences ,Electrocardiography ,Myocardial infarction ,International Component ,screening and diagnosis ,Ejection fraction ,medicine.diagnostic_test ,lcsh:Public aspects of medicine ,Atrial fibrillation ,Heart ,Right bundle branch block ,Middle Aged ,Biological Sciences ,Detection ,Heart Disease ,Infectious Diseases ,Protozoan ,Cardiology ,cardiovascular system ,Medicine ,Female ,Left anterior fascicular block ,medicine.symptom ,Brazil ,4.2 Evaluation of markers and technologies ,Research Article ,Neglected Tropical Diseases ,NHLBI Retrovirus Epidemiology Donor Study-II (REDS-II) ,Adult ,medicine.medical_specialty ,lcsh:Arctic medicine. Tropical medicine ,lcsh:RC955-962 ,Trypanosoma cruzi ,Asymptomatic ,Antibodies ,QRS complex ,Clinical Research ,Internal medicine ,Tropical Medicine ,medicine ,Humans ,Chagas Disease ,cardiovascular diseases ,NHLBI Retrovirus Epidemiology Donor Study-II ,Retrospective Studies ,business.industry ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,medicine.disease ,business - Abstract
Background Blood donor screening leads to large numbers of new diagnoses of Trypanosoma cruzi infection, with most donors in the asymptomatic chronic indeterminate form. Information on electrocardiogram (ECG) findings in infected blood donors is lacking and may help in counseling and recognizing those with more severe disease. Objectives To assess the frequency of ECG abnormalities in T.cruzi seropositive relative to seronegative blood donors, and to recognize ECG abnormalities associated with left ventricular dysfunction. Methods The study retrospectively enrolled 499 seropositive blood donors in São Paulo and Montes Claros, Brazil, and 483 seronegative control donors matched by site, gender, age, and year of blood donation. All subjects underwent a health clinical evaluation, ECG, and echocardiogram (Echo). ECG and Echo were reviewed blindly by centralized reading centers. Left ventricular (LV) dysfunction was defined as LV ejection fraction (EF), Author Summary Chagas disease (ChD), caused by the protozoa Trypanosoma cruzi, is endemic in most Latin America countries and may be transmitted via blood transfusions. Cardiac disease is a major feature of chronically infected patients and may be lethal. Universal blood bank screening for ChD has been established in most Latin American countries, as well as in non-endemic countries with large immigrant populations, including the United States, Canada, Spain and Portugal. Blood donor screening leads to large numbers of new diagnoses of chronic T. cruzi infection. Counseling these individuals should address the recognition of those with more severe disease that deserve to be rigorously evaluated by experienced cardiologists and treated more promptly. The electrocardiogram is an important exam that can help in the recognition of cardiac disease and the evaluation of prognosis in ChD patients, but its role in blood donors has not been studied. The authors describe some electrocardiographic abnormalities that are typical of the infected blood donors, as well ECG abnormalities that help in the identification of those with severe cardiac involvement. These results may guide the evaluations of patients with incidentally detected T. cruzi infection from blood bank testing or public health screening.
- Published
- 2013