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• PETCO 2 peak and VO 2peak were lower in chagas cardiomyopathy patients with adverse events. • PETCO 2 peak and VO 2peak are independent predictors of worse prognosis. • PETCO 2 peak and VO 2peak lower than 32 mmHg and 20 mL.kg.min identify worse prognosis. Functional impairment can be detected from the onset of heart disease in patients with Chagas cardiomyopathy (ChC) and the prognostic value of the end-tidal carbon dioxide at peak exercise (PETCO 2 peak) should be investigated. To verify the prognostic value of PETCO 2 peak in patients with ChC. Seventy-six patients with ChC (49.2 ± 9.8 years, NYHA I-III) were evaluated by echocardiography and Cardiopulmonary Exercise Testing. Patients were followed up to four years and the end-point was defined as cardiovascular death, stroke, or cardiac transplantation. At the end of the follow-up period (29.0 ± 16.0 months), 16 patients (21%) had experienced adverse events. The area under the receiver operating characteristic (ROC) curve to identify the risk of adverse events by PETCO 2 peak in patients with ChC was 0.83 (95% CI: 0.69 to 0.97), and the value of 32 mmHg was the optimal cut point (70% of sensitivity and 85% of specificity). In the Kaplan-Meier diagram, there was a significant difference (p <0.001) between patients with reduced (≤ 32 mmHg) and preserved PETCO 2 peak (>32 mmHg). In the final Cox multivariate model, only reduced PETCO 2 peak (HR 4.435; 95% CI: 1.228 to 16.016, p = 0.023) and VO 2peak (HR 0.869; 95% CI: 0.778 to 0.971, p = 0.013) remained as independent predictors of poor outcome in ChC patients. Reduced PETCO 2 peak and VO2 peak demonstrated valuable prognostic value in patients with ChC. The cutoff points for both functional variables can be used during risk stratification and may help in the development of therapeutic strategies in ChC patients. [ABSTRACT FROM AUTHOR]

To verify the association between Human Activity Profile and functional capacity, functional class and systolic function of the patients with Chagas heart disease (CHD). Sixty-two patients with CHD were evaluated by echocardiography, maximal exercise testing and Human Activity Profile questionnaire. The sample was stratified, according to the values of peak oxygen uptake (low or normal), functional class (symptomatic or asymptomatic), and left ventricular ejection fraction (preserved or systolic dysfunction). Linear regression and two-group comparisons analyses were used. Receiver-operating characteristic analysis was used to determine different cutoff values of the Human Activity Profile for low peak oxygen uptake prediction. Peak oxygen uptake was an independent predictor of Human Activity Profile (R2-adjusted = 0.27). Patients with low peak oxygen uptake had lower scores in Human Activity Profile [difference of 6.9 (95%CI 2.5–11.4)] than those with normal peak oxygen uptake. Symptomatic patients also showed lower scores when compared to the asymptomatic [difference of 6.2 (95%CI 1.7–10.8)]. There was no difference between left ventricular ejection fraction classes. The Human Activity Profile score of 76.5 was the optimal cut point value in predicting low peak oxygen uptake (sensitivity = 66.0% and specificity = 71.8%). The Human Activity Profile questionnaire is associated with functional capacity of patients with CHD and is able to identify individuals with low peak oxygen uptake. Functional impairment is one of the most common clinical findings in all stages and is an important predictor of poor prognosis of the Chagas heart disease; A patient-derived measure of functional capacity is potentially useful in the setting of the Chagas heart disease; The Human Activity Profile questionnaire is effective in the identification of patients with Chagas heart disease with functional impairment and may be a valid method for functional evaluation. [ABSTRACT FROM AUTHOR]