Electrocardiographic abnormalities in Trypanosoma cruzi seropositive and seronegative former blood donors.

BACKGROUND:Blood donor screening leads to large numbers of new diagnoses of Trypanosoma cruzi infection, with most donors in the asymptomatic chronic indeterminate form. Information on electrocardiogram (ECG) findings in infected blood donors is lacking and may help in counseling and recognizing tho...

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Main Authors: Antonio L Ribeiro, Ester C Sabino, Milena S Marcolino, Vera M C Salemi, Barbara M Ianni, Fábio Fernandes, Luciano Nastari, André Antunes, Márcia Menezes, Cláudia Di Lorenzo Oliveira, Vandana Sachdev, Danielle M Carrick, Michael P Busch, Eduard L Murphy, NHLBI Retrovirus Epidemiology Donor Study-II (REDS-II), International Component
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2013-01-01
Series:PLoS Neglected Tropical Diseases
Online Access:http://europepmc.org/articles/PMC3585012?pdf=render
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author Antonio L Ribeiro
Ester C Sabino
Milena S Marcolino
Vera M C Salemi
Barbara M Ianni
Fábio Fernandes
Luciano Nastari
André Antunes
Márcia Menezes
Cláudia Di Lorenzo Oliveira
Vandana Sachdev
Danielle M Carrick
Michael P Busch
Eduard L Murphy
NHLBI Retrovirus Epidemiology Donor Study-II (REDS-II), International Component
author_facet Antonio L Ribeiro
Ester C Sabino
Milena S Marcolino
Vera M C Salemi
Barbara M Ianni
Fábio Fernandes
Luciano Nastari
André Antunes
Márcia Menezes
Cláudia Di Lorenzo Oliveira
Vandana Sachdev
Danielle M Carrick
Michael P Busch
Eduard L Murphy
NHLBI Retrovirus Epidemiology Donor Study-II (REDS-II), International Component
author_sort Antonio L Ribeiro
collection DOAJ
description BACKGROUND:Blood donor screening leads to large numbers of new diagnoses of Trypanosoma cruzi infection, with most donors in the asymptomatic chronic indeterminate form. Information on electrocardiogram (ECG) findings in infected blood donors is lacking and may help in counseling and recognizing those with more severe disease. OBJECTIVES:To assess the frequency of ECG abnormalities in T.cruzi seropositive relative to seronegative blood donors, and to recognize ECG abnormalities associated with left ventricular dysfunction. METHODS:The study retrospectively enrolled 499 seropositive blood donors in São Paulo and Montes Claros, Brazil, and 483 seronegative control donors matched by site, gender, age, and year of blood donation. All subjects underwent a health clinical evaluation, ECG, and echocardiogram (Echo). ECG and Echo were reviewed blindly by centralized reading centers. Left ventricular (LV) dysfunction was defined as LV ejection fraction (EF)<0.50%. RESULTS:Right bundle branch block and left anterior fascicular block, isolated or in association, were more frequently found in seropositive cases (p<0.0001). Both QRS and QTc duration were associated with LVEF values (correlation coefficients -0.159,p<0.0003, and -0.142,p = 0.002) and showed a moderate accuracy in the detection of reduced LVEF (area under the ROC curve: 0.778 and 0.790, both p<0.0001). Several ECG abnormalities were more commonly found in seropositive donors with depressed LVEF, including rhythm disorders (frequent supraventricular ectopic beats, atrial fibrillation or flutter and pacemaker), intraventricular blocks (right bundle branch block and left anterior fascicular block) and ischemic abnormalities (possible old myocardial infarction and major and minor ST abnormalities). ECG was sensitive (92%) for recognition of seropositive donors with depressed LVEF and had a high negative predictive value (99%) for ruling out LV dysfunction. CONCLUSIONS:ECG abnormalities are more frequent in seropositive than in seronegative blood donors. Several ECG abnormalities may help the recognition of seropositive cases with reduced LVEF who warrant careful follow-up and treatment.
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spelling doaj.art-5ad7b48608cf42ab9cf16d8afad2a0d62022-12-21T19:37:56ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352013-01-0172e207810.1371/journal.pntd.0002078Electrocardiographic abnormalities in Trypanosoma cruzi seropositive and seronegative former blood donors.Antonio L RibeiroEster C SabinoMilena S MarcolinoVera M C SalemiBarbara M IanniFábio FernandesLuciano NastariAndré AntunesMárcia MenezesCláudia Di Lorenzo OliveiraVandana SachdevDanielle M CarrickMichael P BuschEduard L MurphyNHLBI Retrovirus Epidemiology Donor Study-II (REDS-II), International ComponentBACKGROUND:Blood donor screening leads to large numbers of new diagnoses of Trypanosoma cruzi infection, with most donors in the asymptomatic chronic indeterminate form. Information on electrocardiogram (ECG) findings in infected blood donors is lacking and may help in counseling and recognizing those with more severe disease. OBJECTIVES:To assess the frequency of ECG abnormalities in T.cruzi seropositive relative to seronegative blood donors, and to recognize ECG abnormalities associated with left ventricular dysfunction. METHODS:The study retrospectively enrolled 499 seropositive blood donors in São Paulo and Montes Claros, Brazil, and 483 seronegative control donors matched by site, gender, age, and year of blood donation. All subjects underwent a health clinical evaluation, ECG, and echocardiogram (Echo). ECG and Echo were reviewed blindly by centralized reading centers. Left ventricular (LV) dysfunction was defined as LV ejection fraction (EF)<0.50%. RESULTS:Right bundle branch block and left anterior fascicular block, isolated or in association, were more frequently found in seropositive cases (p<0.0001). Both QRS and QTc duration were associated with LVEF values (correlation coefficients -0.159,p<0.0003, and -0.142,p = 0.002) and showed a moderate accuracy in the detection of reduced LVEF (area under the ROC curve: 0.778 and 0.790, both p<0.0001). Several ECG abnormalities were more commonly found in seropositive donors with depressed LVEF, including rhythm disorders (frequent supraventricular ectopic beats, atrial fibrillation or flutter and pacemaker), intraventricular blocks (right bundle branch block and left anterior fascicular block) and ischemic abnormalities (possible old myocardial infarction and major and minor ST abnormalities). ECG was sensitive (92%) for recognition of seropositive donors with depressed LVEF and had a high negative predictive value (99%) for ruling out LV dysfunction. CONCLUSIONS:ECG abnormalities are more frequent in seropositive than in seronegative blood donors. Several ECG abnormalities may help the recognition of seropositive cases with reduced LVEF who warrant careful follow-up and treatment.http://europepmc.org/articles/PMC3585012?pdf=render
spellingShingle Antonio L Ribeiro
Ester C Sabino
Milena S Marcolino
Vera M C Salemi
Barbara M Ianni
Fábio Fernandes
Luciano Nastari
André Antunes
Márcia Menezes
Cláudia Di Lorenzo Oliveira
Vandana Sachdev
Danielle M Carrick
Michael P Busch
Eduard L Murphy
NHLBI Retrovirus Epidemiology Donor Study-II (REDS-II), International Component
Electrocardiographic abnormalities in Trypanosoma cruzi seropositive and seronegative former blood donors.
PLoS Neglected Tropical Diseases
title Electrocardiographic abnormalities in Trypanosoma cruzi seropositive and seronegative former blood donors.
title_full Electrocardiographic abnormalities in Trypanosoma cruzi seropositive and seronegative former blood donors.
title_fullStr Electrocardiographic abnormalities in Trypanosoma cruzi seropositive and seronegative former blood donors.
title_full_unstemmed Electrocardiographic abnormalities in Trypanosoma cruzi seropositive and seronegative former blood donors.
title_short Electrocardiographic abnormalities in Trypanosoma cruzi seropositive and seronegative former blood donors.
title_sort electrocardiographic abnormalities in trypanosoma cruzi seropositive and seronegative former blood donors
url http://europepmc.org/articles/PMC3585012?pdf=render
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