ArticlePLoS neglected tropical diseases2025
Left ventricular reverse remodeling: A predictor of survival in chagasic cardiomyopathy patients with a reduced ejection fraction.
Article in PLoS neglected tropical diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prognostic value of the New York Heart Association classification for cardiovascular events and mortality in Chagas cardiomyopathy: a systematic review and meta-analysis with GRADE recommendations.Revista da Sociedade Brasileira de Medicina Tropical · 2026Pooled it
- Reverse Remodelling, Myocardial Recovery and Remission in Heart Failure with Reduced Ejection Fraction: Clinical Implications and Management Strategies.Cardiac failure review · 2025Review
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChagas disease is a major health issue in Latin America and is now spreading globally because of migration. Chronic Chagasic cardiomyopathy (CCC) leads to heart failure with a reduced ejection fraction (HFrEF). Left ventricular reverse remodeling (LVRR), defined as an improved LVEF, is associated with improved outcomes in patients with other HFrEF etiologies. Therefore, we evaluated the relationship between LVRR and survival in CCC patients with an LVEF<40%.
methodsThis retrospective, single-center study included patients diagnosed with CCC and LVEF<40% between January 2006 and September 2021. Patients were divided into two groups: positive RR (PRR; LVEF≥40% or an absolute LVEF increase of ≥ 10%) and negative RR (NRR). Propensity score matching (PSM) was used to account for baseline differences, and Cox proportional hazards models were applied to determine independent predictors of mortality and heart transplantation.
resultsA total of 1,043 patients were evaluated; 221 (21.2%) were classified as having PRR, and 822 (78.8%) were classified as having NRR. PRR status was associated with a 55% lower risk of all-cause mortality and heart transplantation over 15 years (p = 0.002). Multivariate Cox analysis revealed that predictors of total mortality and heart transplantation included NRR status, a worse NYHA class, lower serum sodium levels, larger LV dimensions, and moderate-to-severe tricuspid regurgitation (TR). The PRR predictors were smaller LV dimensions, less mitral regurgitation, and the absence of triple therapy at baseline. NRR patients were more likely to be on triple therapy at baseline.
conclusionsPRR improves survival in CCC patients with HFrEF. Identifying patients with potential for LVRR, alongside early therapeutic interventions, may reduce mortality in this population. Future research should focus on therapies that promote LVRR in patients with CCC.
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