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Exercise stress testing as a predictor of progression of early chronic Chagas heart disease
  1. R Viotti1,
  2. C Vigliano1,
  3. B Lococo1,
  4. M Petti1,
  5. G Bertocchi1,
  6. F De Cecco1,
  7. M G Alvarez1,
  8. S Laucella2,
  9. A Armenti1
  1. 1Hospital Eva Perón, Servicio de Cardiología, Sección Chagas e Insuficiencia cardiaca, San Martín, Buenos Aires, Argentina
  2. 2Instituto Nacional de Parasitología Dr Mario Fatala Chabén, Buenos Aires, Argentina
  1. Correspondence to:
    Dr Rodolfo Viotti
    José Hernández 3440, Villa Ballester, Buenos Aires, Argentina ZC 1653; peron{at}

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It is estimated that about four million people have chagasic heart disease in Latin America. The early detection of those patients who are likely to progress to more severe disease is necessary for appropriate treatment management to prevent further cardiac damage. The detection of ventricular arrhythmias is regarded as an expression of cardiac involvement in chagasic patients1 and it is a common finding during stress testing. The objective of this study was to ascertain whether stress testing has prognostic value for the progression of early chronic Chagas heart disease.


Eight hundred and forty three patients with confirmed positive serology for Trypanosoma cruzi infection were seen between 1984 and 2003 at the Hospital Eva Perón, Buenos Aires, Argentina. All patients were evaluated with ECG, chest radiography, bidimensional echocardiography, and stress testing under basal conditions. Patients were grouped into four stages according to a modified Kuschnir classification.2 Patients in groups 0 (normal ECG and chest radiograph) and I (abnormal ECG and normal chest radiograph) and aged 20–60 …

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