Reduced functional capacity in patients with Chagas disease: a systematic review with meta-analysis
Abstract Reduced peak oxygen uptake (VO2peak) is a common clinical finding in progressive Chagas disease. However, the disease stage in which functional impairment is detectable remains uncertain. The present study compared functional capacity between healthy controls and patients with different cli...
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| Format: | Article |
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Sociedade Brasileira de Medicina Tropical (SBMT)
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| Series: | Revista da Sociedade Brasileira de Medicina Tropical |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822018000400421&lng=en&tlng=en |
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| author | Henrique Silveira Costa Márcia Maria Oliveira Lima Fábio Silva Martins da Costa Ana Thereza Chaves Maria Carmo Pereira Nunes Pedro Henrique Scheidt Figueiredo Manoel Otávio da Costa Rocha |
| author_facet | Henrique Silveira Costa Márcia Maria Oliveira Lima Fábio Silva Martins da Costa Ana Thereza Chaves Maria Carmo Pereira Nunes Pedro Henrique Scheidt Figueiredo Manoel Otávio da Costa Rocha |
| author_sort | Henrique Silveira Costa |
| collection | DOAJ |
| description | Abstract Reduced peak oxygen uptake (VO2peak) is a common clinical finding in progressive Chagas disease. However, the disease stage in which functional impairment is detectable remains uncertain. The present study compared functional capacity between healthy controls and patients with different clinical forms of Chagas disease. A systematic review and meta-analysis (PROSPERO database CRD42017058353) was conducted following a search of the MEDLINE, Web of Science, CINAHL, and LILACS databases from September to December 2017 for articles published in English, Spanish, or Portuguese, with no date restrictions. We included studies that compared the VO2peak between healthy and Chagas disease patients, stratified according to 3 clinical forms [no apparent cardiac disease, non-dilated Chagas heart disease (CHD), and dilated CHD]. Seven cross-sectional studies were included. Chagas disease patients without apparent cardiac disease (n=208) had VO2peak values [mean difference, -1.55ml/kg/min; 95% confidence interval (CI), -4.98ml/kg/min to 1.88ml/kg/min] similar to those of healthy controls (n=105; p=0.38, I2=52%). In non-dilated CHD (n=159), VO2peak was 8.71ml/kg/min lower (95% CI, -13.99 to -3.42ml/kg/min) than in healthy controls (n=59; p=0.001, I2=75%). VO2peak was also significantly lower (mean difference, -9.30ml/kg/min; 95% CI, -11.34 to -7.25ml/kg/min) in dilated CHD patients (n=131) than in healthy controls (n=53; p<0.001, I2=0%). Exercise capacity in Chagas disease patients without apparent cardiac disease is similar to that in healthy controls. Functional impairment in Chagas disease is detectable in the early stages of cardiac involvement, even in the absence of systolic dysfunction and signs of heart failure. |
| first_indexed | 2024-12-12T19:49:34Z |
| format | Article |
| id | doaj.art-75ff260ed68f4037a31bc6cb7db65965 |
| institution | Directory Open Access Journal |
| issn | 1678-9849 |
| language | English |
| last_indexed | 2024-12-12T19:49:34Z |
| publisher | Sociedade Brasileira de Medicina Tropical (SBMT) |
| record_format | Article |
| series | Revista da Sociedade Brasileira de Medicina Tropical |
| spelling | doaj.art-75ff260ed68f4037a31bc6cb7db659652022-12-22T00:14:00ZengSociedade Brasileira de Medicina Tropical (SBMT)Revista da Sociedade Brasileira de Medicina Tropical1678-984951442142610.1590/0037-8682-0158-2018S0037-86822018000400421Reduced functional capacity in patients with Chagas disease: a systematic review with meta-analysisHenrique Silveira CostaMárcia Maria Oliveira LimaFábio Silva Martins da CostaAna Thereza ChavesMaria Carmo Pereira NunesPedro Henrique Scheidt FigueiredoManoel Otávio da Costa RochaAbstract Reduced peak oxygen uptake (VO2peak) is a common clinical finding in progressive Chagas disease. However, the disease stage in which functional impairment is detectable remains uncertain. The present study compared functional capacity between healthy controls and patients with different clinical forms of Chagas disease. A systematic review and meta-analysis (PROSPERO database CRD42017058353) was conducted following a search of the MEDLINE, Web of Science, CINAHL, and LILACS databases from September to December 2017 for articles published in English, Spanish, or Portuguese, with no date restrictions. We included studies that compared the VO2peak between healthy and Chagas disease patients, stratified according to 3 clinical forms [no apparent cardiac disease, non-dilated Chagas heart disease (CHD), and dilated CHD]. Seven cross-sectional studies were included. Chagas disease patients without apparent cardiac disease (n=208) had VO2peak values [mean difference, -1.55ml/kg/min; 95% confidence interval (CI), -4.98ml/kg/min to 1.88ml/kg/min] similar to those of healthy controls (n=105; p=0.38, I2=52%). In non-dilated CHD (n=159), VO2peak was 8.71ml/kg/min lower (95% CI, -13.99 to -3.42ml/kg/min) than in healthy controls (n=59; p=0.001, I2=75%). VO2peak was also significantly lower (mean difference, -9.30ml/kg/min; 95% CI, -11.34 to -7.25ml/kg/min) in dilated CHD patients (n=131) than in healthy controls (n=53; p<0.001, I2=0%). Exercise capacity in Chagas disease patients without apparent cardiac disease is similar to that in healthy controls. Functional impairment in Chagas disease is detectable in the early stages of cardiac involvement, even in the absence of systolic dysfunction and signs of heart failure.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822018000400421&lng=en&tlng=enChagas diseaseFunctional capacityExercise testingSystematic review |
| spellingShingle | Henrique Silveira Costa Márcia Maria Oliveira Lima Fábio Silva Martins da Costa Ana Thereza Chaves Maria Carmo Pereira Nunes Pedro Henrique Scheidt Figueiredo Manoel Otávio da Costa Rocha Reduced functional capacity in patients with Chagas disease: a systematic review with meta-analysis Revista da Sociedade Brasileira de Medicina Tropical Chagas disease Functional capacity Exercise testing Systematic review |
| title | Reduced functional capacity in patients with Chagas disease: a systematic review with meta-analysis |
| title_full | Reduced functional capacity in patients with Chagas disease: a systematic review with meta-analysis |
| title_fullStr | Reduced functional capacity in patients with Chagas disease: a systematic review with meta-analysis |
| title_full_unstemmed | Reduced functional capacity in patients with Chagas disease: a systematic review with meta-analysis |
| title_short | Reduced functional capacity in patients with Chagas disease: a systematic review with meta-analysis |
| title_sort | reduced functional capacity in patients with chagas disease a systematic review with meta analysis |
| topic | Chagas disease Functional capacity Exercise testing Systematic review |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822018000400421&lng=en&tlng=en |
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