Reduced functional capacity in patients with Chagas disease: a systematic review with meta-analysis

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 for...

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Published in:Revista da Sociedade Brasileira de Medicina Tropical 2018-07, Vol.51 (4), p.421-426
Main Authors: Costa, Henrique Silveira, Lima, Márcia Maria Oliveira, Costa, Fábio Silva Martins da, Chaves, Ana Thereza, Nunes, Maria Carmo Pereira, Figueiredo, Pedro Henrique Scheidt, Rocha, Manoel Otávio da Costa
Format: Article
Language:English
Subjects:
Cardiovascular diseases
Chagas disease
Confidence intervals
Coronary artery disease
Disease control
Exercise testing
Functional capacity
Heart
Heart diseases
Impairment
Meta-analysis
Oxygen uptake
Patients
Systematic review
TROPICAL MEDICINE
Vector-borne diseases
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Summary: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
ISSN:0037-8682
1678-9849
1678-9849
DOI:10.1590/0037-8682-0158-2018