Frequency of electrocardiographic alterations and pericardial effusion in patients with uncomplicated malaria
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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/µl), 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.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | American Journal of Cardiology |
| Vol/bind | 165 |
| Sider (fra-til) | 116-123 |
| ISSN | 0002-9149 |
| DOI | |
| Status | Udgivet - 2022 |
Bibliografisk note
Funding Information:
Dr. Dominguez receives support from grant 18-M03-KU from Danida Fellowship Center (Frederiksberg, Denmark) for Holter monitoring with Cortrium C3+ devices.
Funding Information:
The authors are thankful for the help and guidance from Suiane da Costa Negreiros do Valle, Jana?na Alencar, and all employees in health care clinics in Cruzeiro do Sul, Acre, Brazil. Dr. Brainin and Dr. Holm receive grant support from Jette and Hans Henrik Jensen (Copenhagen, Denmark), grant 0129-0003B from The Independent Research Fund Denmark (Odense, Denmark), grant 120620-kms from Dansk Medicinsk Selskab K?benhavn (Copenhagen, Denmark), grant 18-05-2487 from Julie von M?llens Fond (Copenhagen Denmark), grant 18-05-2487 from Knud H?jgaards Fond (Gentofte, Denmark), grant 18-L-0026 from A.P. M?llers L?gefond (Copenhagen, Denmark), grant 18-JU-0485 from Reinholdt W. Jorck og Hustrus Fond (Copenhagen, Denmark), Eva og Henry Fr?nkels Mindefond (Frederiksberg, Denmark), Danish Society of Cardiology (Copenhagen, Denmark), Internal funds at Gentofte Hospital (Gentofte, Denmark), grant TA250419 from Alice og Frimodts Fond (Charlottenlund, Denmark) and grant R373-2021-1201 from Lundbeckfonden (Copenhagen, Denmark). Dr. Wegener receives support from grant 20-R139-A9644-22165 by Danish Heart Association (Copenhagen, Denmark), grant 20-1257 by William Demant (Sm?rum, Denmark), grant 20-01-1076 by Knud H?jgaards Fond (Gentofte, Denmark), grant 20-JU-0145 by Reinholdt W. Jorck og Hustrus Fond (Copenhagen, Denmark). Dr. Kaagaard receives support from grant NNF20OC0062782 by Novo Nordisk Fonden (Hellerup, Denmark). Dr. Gomes receives support from grant 142306/2020-7 by National Council for Scientific and Technological Development (CNPq) (Bras?lia, Brazil). Secondary funding sources not specifically for the Malaria Heart Study include the following: Dr. Romero Farias Marinho receives support from grant 2020/06747-4 by the S?o Paulo Research Foundation (S?o Paulo, Brazil) and grant 302917/2019-5 by National Council for Scientific and Technological Development (CNPq) (Bras?lia, Brazil).
Funding Information:
Dr. Brainin and Dr. Holm receive grant support from Jette and Hans Henrik Jensen (Copenhagen, Denmark), grant 0129-0003B from The Independent Research Fund Denmark (Odense, Denmark), grant 120620-kms from Dansk Medicinsk Selskab København (Copenhagen, Denmark), grant 18-05-2487 from Julie von Müllens Fond (Copenhagen Denmark), grant 18-05-2487 from Knud Højgaards Fond (Gentofte, Denmark), grant 18-L-0026 from A.P. Møllers Lægefond (Copenhagen, Denmark), grant 18-JU-0485 from Reinholdt W. Jorck og Hustrus Fond (Copenhagen, Denmark), Eva og Henry Frænkels Mindefond (Frederiksberg, Denmark), Danish Society of Cardiology (Copenhagen, Denmark), Internal funds at Gentofte Hospital (Gentofte, Denmark), grant TA250419 from Alice og Frimodts Fond (Charlottenlund, Denmark) and grant R373-2021-1201 from Lundbeckfonden (Copenhagen, Denmark). Dr. Wegener receives support from grant 20-R139-A9644-22165 by Danish Heart Association (Copenhagen, Denmark), grant 20-1257 by William Demant (Smørum, Denmark), grant 20-01-1076 by Knud Højgaards Fond (Gentofte, Denmark), grant 20-JU-0145 by Reinholdt W. Jorck og Hustrus Fond (Copenhagen, Denmark). Dr. Kaagaard receives support from grant NNF20OC0062782 by Novo Nordisk Fonden (Hellerup, Denmark). Dr. Gomes receives support from grant 142306/2020-7 by National Council for Scientific and Technological Development (CNPq) (Brasília, Brazil). Secondary funding sources not specifically for the Malaria Heart Study include the following: Dr. Romero Farias Marinho receives support from grant 2020/06747-4 by the São Paulo Research Foundation (São Paulo, Brazil) and grant 302917/2019-5 by National Council for Scientific and Technological Development (CNPq) (Brasília, Brazil).
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