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1. Jorge Adas Dib. Determinantes progn?sticos de pacientes portadores de insufici?ncia card?aca cr?nica secund?ria ? cardiomiopatia da doen?a de Chagas na lista de espera para transplante card?aco.

Degree: 2008, Faculdade de Medicina de São José do Rio Preto

No previous study has addressed the question of prognostic determinants for patients with Chagas? cardiomyopathy at the terminal stage listed for heart transplantation. Casuistic and Method: All patients listed for heart transplantation at our institution from August, 2000 to March, 2005 were considered for the study. Patients removed from the waiting list for clinical status improvement were excluded from the investigation. Patients were followed until death, cardiac transplantation or the end of the study period. Cardiac transplant recipients were censored at the time of transplantation. No patient was lost to follow up. A Cox regression hazards model was used to establish independent predictors of all-cause mortality. Variables previously demonstrated to predict mortality in either Chagas or non-Chagas? disease heart failure were entered the univariate analysis. Separate analyses were performed for Chagas and non-Chagas? disease patients. Results: Median follow up was 32 (15,121) days in Chagas disease and 79 (14,151) days in non-Chagas? disease patients. In Chagas disease patients, the hemodynamic instability (p=0.01; hazard ratio=0,077, 95% confidence interval, 0.01 to 0.58) as well as the transpulmonary gradient (p=0.02; hazard ratio=1.15, 95% confidence interval, 1.02 to 1.30) were retained as independent predictors of all-cause mortality. Serum sodium levels (p=0.002; hazard ratio=0.81; 95% confidence interval, 0.71 to 0.93) was independent predictor of all-cause mortality for non-Chagas? disease patients. Conclusion: The hemodynamic instability and transpulmonary gradient were independent predictors of all-cause mortality for Chagas? disease patients listed for heart transplantation. A larger, prospective cohort study is needed to validate our findings.

At? agora nenhum estudo preocupou-se em estabelecer determinantes progn?sticos para pacientes com insufici?ncia card?aca cr?nica terminal secund?ria ? cardiomiopatia da doen?a de Chagas na fila de espera para transplante card?aco. Casu?stica e M?todo: Todos os pacientes alocados em fila de espera de transplante card?aco em nossa institui??o, de agosto de 2000 a mar?o de 2005, foram inicialmente considerados para o estudo. Os pacientes que foram removidos da lista de espera em virtude de melhora no estado cl?nico foram retirados do estudo. Os pacientes foram acompanhados at? a morte, transplante card?aco ou a data final estipulada para o estudo. Os pacientes receptores de transplante de cora??o foram retirados do estudo na data em que o ato operat?rio ocorreu. N?o se perdeu contato com os pacientes durante o acompanhamento cl?nico enquanto na fila de espera de transplante card?aco. O modelo de an?lise de riscos proporcionais de Cox foi utilizado para se estabelecer vari?veis de predi??o independentes de mortalidade geral. As vari?veis que eram capazes de predizer mortalidade geral em pacientes com insufici?ncia card?aca cr?nica secund?ria ? cardiomiopatia da doen?a de Chagas ou a outras cardiomiopatias foram utilizadas no modelo univariado. An?lises…

Advisors/Committee Members: Reinaldo Azoubel, Reinaldo Bulgarelli Bestetti, Alfredo José Mansur, Augusto Cardinalli Neto, Antonio Carlos Pereira-Barretto, Tatiana Assad Domingos Theodoropoulos.

Subjects/Keywords: Trypanosomiasis Americana; Doen?a de Chagas; Insufici?ncia Card?aca; Transplante Card?aco; Progn?stico.; CARDIOLOGIA; Trypanosoma Cruzi; Transplante de Cora?; Trypanosomiasis American; Chagas? Disease; Heart Failure; Heart Transplantation; Outcome.; Efermedad de Chagas; Trasplante de Corazón; Pronóstico; Prognosis

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APA (6th Edition):

Dib, J. A. (2008). Determinantes progn?sticos de pacientes portadores de insufici?ncia card?aca cr?nica secund?ria ? cardiomiopatia da doen?a de Chagas na lista de espera para transplante card?aco. (Thesis). Faculdade de Medicina de São José do Rio Preto. Retrieved from http://bdtd.famerp.br//tde_busca/arquivo.php?codArquivo=197

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

Dib, Jorge Adas. “Determinantes progn?sticos de pacientes portadores de insufici?ncia card?aca cr?nica secund?ria ? cardiomiopatia da doen?a de Chagas na lista de espera para transplante card?aco.” 2008. Thesis, Faculdade de Medicina de São José do Rio Preto. Accessed October 22, 2019. http://bdtd.famerp.br//tde_busca/arquivo.php?codArquivo=197.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

Dib, Jorge Adas. “Determinantes progn?sticos de pacientes portadores de insufici?ncia card?aca cr?nica secund?ria ? cardiomiopatia da doen?a de Chagas na lista de espera para transplante card?aco.” 2008. Web. 22 Oct 2019.

Vancouver:

Dib JA. Determinantes progn?sticos de pacientes portadores de insufici?ncia card?aca cr?nica secund?ria ? cardiomiopatia da doen?a de Chagas na lista de espera para transplante card?aco. [Internet] [Thesis]. Faculdade de Medicina de São José do Rio Preto; 2008. [cited 2019 Oct 22]. Available from: http://bdtd.famerp.br//tde_busca/arquivo.php?codArquivo=197.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Dib JA. Determinantes progn?sticos de pacientes portadores de insufici?ncia card?aca cr?nica secund?ria ? cardiomiopatia da doen?a de Chagas na lista de espera para transplante card?aco. [Thesis]. Faculdade de Medicina de São José do Rio Preto; 2008. Available from: http://bdtd.famerp.br//tde_busca/arquivo.php?codArquivo=197

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

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