Arq Bras Cardiol: Imagem cardiovasc 2020; 33(4): 1-8

Echocardiography and Analysis of Subclinical Cardiovascular Diseases in Indigenous People Living in Different Degrees of Urbanization: Project of Atherosclerosis Among Indigenous Populations (Pai)

DOI: 10.47593/2675-312X/20203304eabc78

Abstract

Background

The urbanization process impacts the burden of cardiovascular disease (CVD). Indigenous populations can undergo a devastating epidemiological transition.

Objective

The present study aimed to describe the Project of Atherosclerosis among Indigenous Populations (PAI) study protocol for assessing echocardiographic images and subclinical CVD in indigenous populations according to the degree of urbanization and report its preliminary results.

Methods

The PAI is a cross-sectional study that includes volunteers aged 30–70 years among Brazilian indigenous groups exposed to low and advanced stages of urbanization (Fulni-ô and Truká, respectively) and an urban control group. Individuals with known CVD or who were on hemodialysis were excluded. The pilot study began in Fulni-ô territory in September 2016. The participants underwent clinical and laboratory evaluations, electrocardiography, carotid artery ultrasound, and a comprehensive echocardiography protocol including global longitudinal strain (GLS) assessed by speckle tracking. The preliminary results are described by participant sex in univariate analysis.

Results

The pilot study evaluated the protocol used in 55 Fulni-ô individuals (mean age, 48.7 ± 12.0 years; 80% women). Traditional risk factors such as hypertension, diabetes, and dyslipidemia were found in 40%, 36%, and 54% of participants, respectively, without significant statistical differences between the sexes. Tobacco use was extremely prevalent, reported in 91% of participants. Most echocardiographic parameters were within the normal range; however, mean GLS was 17.3 ± 3.4% (p = 0.73 between sexes).

Conclusion

We described the PAI study protocol for assessing subclinical CVD and risk factors in indigenous populations by urbanization stage. Its preliminary results suggest a high prevalence of these factors in the indigenous population exposed to a lower degree of urbanization.