requency of Electrocardiographic Alterations and Pericardial Effusion in Patients With Uncomplicated Malari

Autor(es):Mostrar menos -

Kaagaard, Molly D. ^{[1, 2]} ; Matos, Luan O. ^[1] ; Holm, Anna Engell ^{[1, 2]} ; Gomes, Laura Cordeiro ^[3] ; Wegener, Alma ^{[1, 2]} ; Lima, Karine O. ^[1] ; Vieira, Isabelle V. M. ^[1] ; de Souza, Rodrigo Medeiros ^[1] ; Marinho, Claudio Romero Farias ^[3] ; Hviid, Lars ^[4] ; Vestergaard, Lasse S. ^[5] ; Dominguez, Helena ^[6] ; Biering-Sorensen, Tor ^{[2, 7]} ; Brainin, Philip ^{[1, 2]} ; Silvestre, Odison M. ^[8]

Afiliação do(s) autor(es)

^[1] Univ Fed Acre, Multidisciplinary Ctr, Campus Floresta, Cruzeiro Do Sul - Brazil

^[2] Copenhagen Univ Hosp Herlev & Gentofte, Dept Cardiol, Hellerup - Denmark

^[3] Univ Sao Paulo, Dept Parasitol, Inst Biomed Sci, Sao Paulo - Brazil

^[4] Univ Copenhagen, Ctr Med Parasitol, Dept Immunol & Microbiol, Copenhagen - Denmark

^[5] Univ Copenhagen, Fac Biomed Sci, Copenhagen - Denmark

^[6] Statens Serum Inst, Natl Malaria Reference Lab, Dept Bacteria Parasites & Fungi, Copenhagen - Denmark

^[7] Copenhagen Univ Hosp Bispebjerg & Frederiksberg, Dept Cardiol, Copenhagen - Denmark

^[8] Univ Fed Acre, Hlth & Sport Sci Ctr, Rio Branco - Brazil

• Tipo de documento: Artigo Científico
• Fonte: AMERICAN JOURNAL OF CARDIOLOGY; v. 165, p. 116-123, FEB 15 2022.
• Citações Web of Science: 0

Resumo

Studies have proposed that malaria may lead to electrocardiographic (ECG) changes and pericardial inflammation. We aimed to investigate the frequency of ECG alterations, determined by ECG and Holter monitoring, and pericardial effusion in patients with malaria infection. We performed a prospective observational study of adult patients with uncomplicated malaria in Amazonas, Brazil. Peripheral blood smears, ECG, and bedside echocardiography were conducted before antimalarial treatment and repeated at follow-up after completed treatment. We evaluated the diagnostic value of PR-segment depression, PR-segment elevation, and Spodick's sign for detecting pericardial effusion. A subset of patients underwent Holter monitoring at baseline. Among 98 cases of uncomplicated malaria (55% men; mean age 40 years; median parasite density 1,774/mu l), 75 had Plasmodium vivax, 22 Plasmodium falciparum, and 1 had mixed infection. At baseline, 17% (n = 17) had PR-segment depression, 12% (n = 12) PR-segment elevation, 3% (n = 2) Spodick's sign, and the prevalence of pericardial effusion was 9% (n = 9). ECG alterations had sensitivities of 22% to 89% and specificities of 88% to 100% for detecting pericardial effusion at baseline. PR-segment depression had the best accuracy (sensitivity 89%, specificity 90%). Of the 25 patients, 4 patients who did not have pericardial effusion, displayed nonsustained ventricular tachycardia, determined by Holter monitoring (median duration 43 hours). Follow-up examination data were obtained for 71 patients (median 31 days), for whom PR-segment depression, elevation, and pericardial effusion had reduced significantly (p < 0.05). In conclusion, our findings suggest that ECG alterations may be useful to detect pericardial effusion in malaria and that these findings decrease after completed antimalarial treatment. (C) 2021 Elsevier Inc. All rights reserved. (AU)

• Processo FAPESP: 20/06747-4 - Estudo da resposta imune humoral nas infecções recorrentes por Plasmodium vivax em gestantes da região amazônica
• Beneficiário: Cláudio Romero Farias Marinho
• Modalidade de apoio: Auxílio à Pesquisa - Regular