• CEUS is useful in the diagnostic work-up shortly after liver transplant • CEUS identifies the hepatic artery thrombosis with reliability • There is little information about DUS and CEUS findings in the ASS • DUS and CEUS offer functional information useful in the diagnosis of ASS.

ObjectiveTo describe the hospital mortality and associated clinical and echocardiographic variables in patients with rheumatic disease who underwent double valve replacement surgery.MethodsThis is a cross sectional descriptive study of mortality, performed in a referral hospital in Salvador, Bahia. Records from patients with rheumatic disease who underwent double valve replacement surgery during the years 2007-2011 were analyzed.ResultsThe studied sample comprises 104 patients and 60 (57.7%) were male. The mean age was 38.04±14.45. Sixty five bioprostheses and 38 mechanical prostheses were used in these patients at the time of surgery. There were statistically significant differences between the two groups, when we analyzed the following variables: the mean age (36.30±13.03 vs. 45.35±17.8 years-old, P=0.011), mean hemoglobin (11.10±2.19 vs. 9.22±2.26 g/dL, P=0.002), mean hematocrit (34.22±5.86 vs. 28.44±6.62%, P<0.001). New York Heart Association functional class III and IV (NYHA) (P=0.022) was statistically associated with mortality.ConclusionWe concluded that the mean hemoglobin/hematocrit level and the NYHA functional class was the major variables associated to the mortality among these patients. Based on these data one may concern about the patient best moment for surgery and the patient hemoglobin level.

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Chagas’ disease, caused by Trypanosoma cruzi, is an important parasitic disease in Latin America, affecting more than 8 millions of people. The chronic phase is characterized by commitment of heart or digestive organs and the reason for the development of one clinical form or another is not well known. It is speculated that host and parasite genetic characteristics contribute for it. LT-α is an inflammatory cytokine, important in the organization and maintenance of the inflammatory process by stimulating adhesion molecules, such as VCAM, ICAM and E-selectin. Polymorphism on LT-α gene, position +252, were analyzed on subjects (n= 295) from an endemic area for Chagas’ disease grouped according to serology for T. cruzi and with clinical form (cardiac or indeterminate forms).Expression of LT-α was evaluated in culture supernatants and by flow cytometry. Presence of G allele was significantly more frequent in patients with heart commitment (cardiac form) (p=0.016, OR=2.4). Patients with cardiac form produced significantly more LT-α than individuals with the indeterminate form. Furthermore, infected individuals with G allele produced significantly higher levels of LT-α than those without G allele. CD8+ T lymphocytes were the major source of LT-α in basal condition and after stimulation with specific antigens. This study presents genetic and biological evidence for a role of LT-α in the development of cardiac form of Chagas’ disease.

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