Accuracy and reliability of focused echocardiography in patients with Chagas disease from endemic areas: SaMi-Trop cohort study

<h4>Background</h4> Chagas disease remains a major cause of cardiovascular death in endemic areas. Focused echocardiography (FoCUS) is a point-of-care means of assessing cardiac function which can be useful for the diagnosis of cardiac involvement. <h4>Objective</h4> This stu...

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Autores principales:	Isabella Morais Martins Barros, Marcio Vinicius L. Barros, Larissa Natany Almeida Martins, Antonio Luiz P. Ribeiro, Raul Silva Simões de Camargo, Claudia Di Lorenzo Oliveira, Ariela Mota Ferreira, Lea Campos de Oliveira, Ana Luiza Bierrenbach, Desireé Sant´Ana Haikal, Ester Cerdeira Sabino, Clareci S. Cardoso, Maria Carmo Pereira Nunes
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/4a347c6cd4e845bc886f586b3cb2b836
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spelling	oai:doaj.org-article:4a347c6cd4e845bc886f586b3cb2b8362021-11-11T07:14:42ZAccuracy and reliability of focused echocardiography in patients with Chagas disease from endemic areas: SaMi-Trop cohort study1932-6203https://doaj.org/article/4a347c6cd4e845bc886f586b3cb2b8362021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8568132/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4> Chagas disease remains a major cause of cardiovascular death in endemic areas. Focused echocardiography (FoCUS) is a point-of-care means of assessing cardiac function which can be useful for the diagnosis of cardiac involvement. <h4>Objective</h4> This study aims evaluating the characteristics of validity and reliability of FoCUS applied on Chagas disease patients. <h4>Methods</h4> Patients with Chagas disease coming from an endemic area were selected from a large cohort (SaMi-Trop). A simplified echocardiogram with only three images was extracted from the conventional echocardiogram performed in this cohort. The images were evaluated by an observer who was blinded to the clinical and echocardiographic data, to determine the accuracy and reliability of FoCUS for cardiac assessment. The analysis constituted of 5 prespecified variables, dichotomized in absence or presence: left ventricular (LV) size and systolic function, right ventricular (RV) size and systolic function, and LV aneurysm. <h4>Results</h4> We included 725 patients with a mean age of 63.4 ± 12.3 years, 483 (67%) female. Abnormal electrocardiogram was observed in 81.5% of the patients. Left and right ventricular dysfunctions were found in 103 (14%) and 49 (7%) of the patients, respectively. Sensitivity, specificity, positive predictive value and negative predictive value were 84%, 94%, 70% and 97% for LV enlargement and 81%, 93%, 68% and 97% for LV systolic dysfunction, respectively, and 46%, 99%, 60% and 98% for RV dilatation, and 37%, 100%, 100% and 96% for RV dysfunction, respectively. Inter and intraobserver agreement were 61% and 87% for LV enlargement and 63% and 92% for LV dysfunction, respectively, and 50% and 49% for RV size and 46% and 79% for RV dysfunction, respectively. LV apical aneurysm was found in 45 patients (6.2%) with the lowest sensitivity of FoCUS study (11%; 95% CI 2–28%). <h4>Conclusions</h4> FoCUS showed satisfactory values of validity and reliability for assessment of cardiac chambers in patients with Chagas disease, except for apical aneurysm. This tool can identify heart disease with potential impact on patient management in the limited-resource setting.Isabella Morais Martins BarrosMarcio Vinicius L. BarrosLarissa Natany Almeida MartinsAntonio Luiz P. RibeiroRaul Silva Simões de CamargoClaudia Di Lorenzo OliveiraAriela Mota FerreiraLea Campos de OliveiraAna Luiza BierrenbachDesireé Sant´Ana HaikalEster Cerdeira SabinoClareci S. CardosoMaria Carmo Pereira NunesPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Isabella Morais Martins Barros Marcio Vinicius L. Barros Larissa Natany Almeida Martins Antonio Luiz P. Ribeiro Raul Silva Simões de Camargo Claudia Di Lorenzo Oliveira Ariela Mota Ferreira Lea Campos de Oliveira Ana Luiza Bierrenbach Desireé Sant´Ana Haikal Ester Cerdeira Sabino Clareci S. Cardoso Maria Carmo Pereira Nunes Accuracy and reliability of focused echocardiography in patients with Chagas disease from endemic areas: SaMi-Trop cohort study
description	<h4>Background</h4> Chagas disease remains a major cause of cardiovascular death in endemic areas. Focused echocardiography (FoCUS) is a point-of-care means of assessing cardiac function which can be useful for the diagnosis of cardiac involvement. <h4>Objective</h4> This study aims evaluating the characteristics of validity and reliability of FoCUS applied on Chagas disease patients. <h4>Methods</h4> Patients with Chagas disease coming from an endemic area were selected from a large cohort (SaMi-Trop). A simplified echocardiogram with only three images was extracted from the conventional echocardiogram performed in this cohort. The images were evaluated by an observer who was blinded to the clinical and echocardiographic data, to determine the accuracy and reliability of FoCUS for cardiac assessment. The analysis constituted of 5 prespecified variables, dichotomized in absence or presence: left ventricular (LV) size and systolic function, right ventricular (RV) size and systolic function, and LV aneurysm. <h4>Results</h4> We included 725 patients with a mean age of 63.4 ± 12.3 years, 483 (67%) female. Abnormal electrocardiogram was observed in 81.5% of the patients. Left and right ventricular dysfunctions were found in 103 (14%) and 49 (7%) of the patients, respectively. Sensitivity, specificity, positive predictive value and negative predictive value were 84%, 94%, 70% and 97% for LV enlargement and 81%, 93%, 68% and 97% for LV systolic dysfunction, respectively, and 46%, 99%, 60% and 98% for RV dilatation, and 37%, 100%, 100% and 96% for RV dysfunction, respectively. Inter and intraobserver agreement were 61% and 87% for LV enlargement and 63% and 92% for LV dysfunction, respectively, and 50% and 49% for RV size and 46% and 79% for RV dysfunction, respectively. LV apical aneurysm was found in 45 patients (6.2%) with the lowest sensitivity of FoCUS study (11%; 95% CI 2–28%). <h4>Conclusions</h4> FoCUS showed satisfactory values of validity and reliability for assessment of cardiac chambers in patients with Chagas disease, except for apical aneurysm. This tool can identify heart disease with potential impact on patient management in the limited-resource setting.
format	article
author	Isabella Morais Martins Barros Marcio Vinicius L. Barros Larissa Natany Almeida Martins Antonio Luiz P. Ribeiro Raul Silva Simões de Camargo Claudia Di Lorenzo Oliveira Ariela Mota Ferreira Lea Campos de Oliveira Ana Luiza Bierrenbach Desireé Sant´Ana Haikal Ester Cerdeira Sabino Clareci S. Cardoso Maria Carmo Pereira Nunes
author_facet	Isabella Morais Martins Barros Marcio Vinicius L. Barros Larissa Natany Almeida Martins Antonio Luiz P. Ribeiro Raul Silva Simões de Camargo Claudia Di Lorenzo Oliveira Ariela Mota Ferreira Lea Campos de Oliveira Ana Luiza Bierrenbach Desireé Sant´Ana Haikal Ester Cerdeira Sabino Clareci S. Cardoso Maria Carmo Pereira Nunes
author_sort	Isabella Morais Martins Barros
title	Accuracy and reliability of focused echocardiography in patients with Chagas disease from endemic areas: SaMi-Trop cohort study
title_short	Accuracy and reliability of focused echocardiography in patients with Chagas disease from endemic areas: SaMi-Trop cohort study
title_full	Accuracy and reliability of focused echocardiography in patients with Chagas disease from endemic areas: SaMi-Trop cohort study
title_fullStr	Accuracy and reliability of focused echocardiography in patients with Chagas disease from endemic areas: SaMi-Trop cohort study
title_full_unstemmed	Accuracy and reliability of focused echocardiography in patients with Chagas disease from endemic areas: SaMi-Trop cohort study
title_sort	accuracy and reliability of focused echocardiography in patients with chagas disease from endemic areas: sami-trop cohort study
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/4a347c6cd4e845bc886f586b3cb2b836
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Accuracy and reliability of focused echocardiography in patients with Chagas disease from endemic areas: SaMi-Trop cohort study

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