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Background: Risk stratification is paramount for treatment of patients with chronic Chagas disease (CCD). The exercise stress test (EST) may be useful in the risk stratification of patients with this condition, but few studies have been performed in patients with CCD., Methods: This was a longitudinal, retrospective cohort study. A total of 339 patients followed at our institution from January 2000 to December 2010 were screened. A total of 76 (22%) patients underwent the EST. The Cox proportional hazards model was used to identify independent predictors of all-cause mortality., Results: Sixty-five (85%) patients were alive and 11 (14%) patients died by the study's close. In the univariate analysis, decreased systolic blood pressure (BP) at the peak of exercise and the double product were associated with all-cause mortality. However, in the multivariate analysis, only systolic BP at the peak of exercise was independently associated with all-cause mortality [hazard ratio 0.97 (95% confidence interval 0.94 to 0.99), p=0.02]., Conclusion: Systolic BP at the peak of EST is an independent predictor of mortality in patients with CCD., (© The Author(s) 2023. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

Introduction: Considering the importance of ventricular arrhythmias in the prediction of sudden cardiac death in chronic Chagas heart disease, the aim of the present study was to associate late potentials observed in the signal-averaged electrocardiogram (SAECG) with either non-sustained ventricular tachycardia in the 24-hour Holter monitoring or reduced left ventricular ejection fraction in the 2-dimension echocardiogram., Methods: This was a retrospective transversal study. The medical charts of 49 patients with chronic Chagas heart disease that underwent 24-hour Holter monitoring at our institution from September 2012 to December 2015 were reviewed. In the univariate analysis, variables associated with SAECG at a p value <0.05 were entered a multivariate stepwise logistic regression analysis through the model forward. A p value <0.05 was considered to have statistical significance., Results: In the univariate analysis, right bundle branch block, left atrial diameter, left ventricular systolic diameter, and left ventricular ejection fraction were associated with late potential in the SAECG. In the multivariate analysis, however, right bundle branch block and left atrial diameter were retained as independent predictors of late potentials in the SAECG., Conclusions: Neither ventricular arrhythmias in the 24-Holter monitoring nor reduced left ventricular ejection fraction in the 2-D echocardiogram were associated with late potentials in the SAECG of patients with chronic Chagas heart disease., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Objective: To verify the possible association between the levels of serum ferritin and the degree of obstructive coronary artery disease., Methods: 115 patients with coronary arteriography and concomitant evaluation of serum ferritin were studied. The adopted cut-off values were 80 ng/ml for women and 120 ng/ml for men., Results: The mean ferritin levels for males and females were 133.9 +/- 133.8 ng/ml and 214.6 +/- 217.2 ng/ml, respectively (p=0.047). It was observed that 44.1% of the women had normal serum ferritin levels in comparison to 30.9% of the men (p=0.254). In the patients without obstructive coronary artery disease or with less severe obstructions (group A) the serum ferritin level was 222.3 +/- 325 ng/ml. On the other hand, for those with moderate (group B) and severe obstructions (group C) the levels were 145.6+-83.7 ng/ml and 188.9 +/- 150.6 ng/ml, respectively. There was no correlation between the degree of coronary artery disease and the mean level of serum ferritin. Regarding the cut-off value, the number of women with serum ferritin level > 80 ng/ml in groups B+C or only C was significantly higher than the number of women in group A (ODDS RATIO 9.71 with 95%CI from 1.63 to 57.72). For males there was no significant difference between the number of cases above or below the cut-off values (ODDS RATIO 0.92 with 95%CI from 0.28 to 2.95)., Conclusion: It was verified that women with serum ferritin levels > 80 ng/mL presented more severe obstructive coronary artery disease than women with lower levels. In men, the serum ferritin level was not a predictor element of the degree of obstruction.

In this study we compared the effect of temperature variation (> or = 32 degrees C to < or = 27 degrees C) on latency differences median to ulnar (ringdiff), median to radial (thumbdiff), palmar median to ulnar (palmdiff) and the sum of three, the combined sensory index (CSI), in 15 controls and 12 patients with carpal tunnel syndrome (CTS). After cooling, ringdiff was the most reliable technique with little variation in both controls and patients; thumbdiff decreased dramatically in controls and could even come within normal limits in patients; palmdiff increased only in patients; CSI decreased significantly in controls and showed a slight increase in patients with no loss in electrodiagnosis accuracy. The high increase of palmdiff in patients, and the high decrease of thumbdiff in controls, after cooling, could not be explained only for fiber size in the nerve trunks. We concluded that for CTS electrodiagnosis even latency differences in same person/same limb could be significantly modified after cooling not previously emphasized in literature.