Electrocardiographic abnormalities in Chagas disease in the general population: A systematic review and meta-analysis.
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Authors
Glisic, Marija
Echeverría, Luis E
Bramer, Wichor M
Bano, Arjola
Stringa, Najada
Zaciragic, Asija
Kraja, Bledar
Asllanaj, Eralda
Chowdhury, Rajiv
Morillo, Carlos A
Rueda-Ochoa, Oscar L
Franco, Oscar H
Muka, Taulant
Publication Date
2018-06Journal Title
PLoS Negl Trop Dis
ISSN
1935-2727
Publisher
Public Library of Science (PLoS)
Volume
12
Issue
6
Pages
e0006567
Language
eng
Type
Article
Physical Medium
Electronic-eCollection
Metadata
Show full item recordCitation
Rojas, L. Z., Glisic, M., Pletsch-Borba, L., Echeverría, L. E., Bramer, W. M., Bano, A., Stringa, N., et al. (2018). Electrocardiographic abnormalities in Chagas disease in the general population: A systematic review and meta-analysis.. PLoS Negl Trop Dis, 12 (6), e0006567. https://doi.org/10.1371/journal.pntd.0006567
Abstract
BACKGROUND: Chagas disease (CD) is a major public health concern in Latin America and a potentially serious emerging threat in non-endemic countries. Although the association between CD and cardiac abnormalities is widely reported, study design diversity, sample size and quality challenge the information, calling for its update and synthesis, which would be very useful and relevant for physicians in non-endemic countries where health care implications of CD are real and neglected. We performed to systematically review and meta-analyze population-based studies that compared prevalence of overall and specific ECG abnormalities between CD and non-CD participants in the general population. METHODS: Six databases (EMBASE, Ovid Medline, Web of Science, Cochrane Central, Google Scholar and Lilacs) were searched systematically. Observational studies were included. Odds ratios (OR) were computed using random-effects model. RESULTS: Forty-nine studies were selected, including 34,023(12,276 CD and 21,747 non-CD). Prevalence of overall ECG abnormalities was higher in participants with CD (40.1%; 95%CIs=39.2-41.0) compared to non-CD (24.1%; 95%CIs=23.5-24.7) (OR=2.78; 95%CIs=2.37-3.26). Among specific ECG abnormalities, prevalence of complete right bundle branch block (RBBB) (OR=4.60; 95%CIs=2.97-7.11), left anterior fascicular block (LAFB) (OR=1.60; 95%CIs=1.21-2.13), combination of complete RBBB/LAFB (OR=3.34; 95%CIs=1.76-6.35), first-degree atrioventricular block (A-V B) (OR=1.71; 95%CIs=1.25-2.33), atrial fibrillation (AF) or flutter (OR=2.11; 95%CIs=1.40-3.19) and ventricular extrasystoles (VE) (OR=1.62; 95%CIs=1.14-2.30) was higher in CD compared to non-CD participants. CONCLUSIONS: This systematic review and meta-analysis provides an update and synthesis in this field. This research of observational studies indicates a significant excess in prevalence of ECG abnormalities (40.1%) related to T. cruzi infection in the general population from Chagas endemic regions, being the most common ventricular (RBBB and LAFB), and A-V B (first-degree) node conduction abnormalities as well as arrhythmias (AF or flutter and VE). Also, prevalence of ECG alterations in children was similar to that in adults and suggests earlier onset of cardiac disease.
Keywords
Heart Conduction System, Humans, Chagas Disease, Chagas Cardiomyopathy, Electrocardiography, Prevalence, Odds Ratio, Adult, Child, Female, Male, Arrhythmias, Cardiac, Observational Studies as Topic
Sponsorship
Medical Research Council (MR/L003120/1)
British Heart Foundation (None)
Identifiers
External DOI: https://doi.org/10.1371/journal.pntd.0006567
This record's URL: https://www.repository.cam.ac.uk/handle/1810/280535
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