The study prospectively enrolled 232 patients (143 men) with Chagas cardiomyopathy (mean age, 48 卤 12 years). End points were death or cardiac transplantation.
During a mean follow-up of 3.4 years, 107 patients had an adverse cardiac event, with an overall events rate of 13.2/year. Cox proportional hazards model was used with New York Heart Association functional class, LV ejection fraction, right ventricular function, indexed left atrial volume, E/e鈥?ratio, and the statistical interaction term between E/e鈥?ratio and LV ejection fraction. The effect of E/e鈥?ratio on mortality depended on the degree of LV systolic dysfunction. An increasing E/e鈥?ratio was a strong predictor of outcome in patients with mild to moderate LV dysfunction but was inversely associated with mortality in patients with severe systolic dysfunction.
This study demonstrated the role of the interaction between LV ejection fraction and E/e鈥?ratio in predicting prognosis in Chagas cardiomyopathy patients. The E/e鈥?ratio had a stronger prognostic value in patients with mild and moderate LV dysfunction and was inversely associated with mortality in patients with advanced systolic heart failure.