Caracterização do aneurisma apical da cardiopatia chagásica crônica mediante uso de corregistro de imagens cintilográficas

Abstract

MethodsThirteen patients (mean aged 48 ± 3 years, nine male) with chronic Chagas' heart disease, defined as positive serology and epidemiological history, were investigated in a clinical trial designed to analyze the correlation between cardiac sympathetic denervation and myocardial perfusion changes 8 . They had normal global systolic ventricular function (LV ejection fraction was 55 ± 2%) and no ventricular dilation, yet showed segmental wall motion abnormalities on MUGA-SPECT. Of these patients, four had apical aneurysm, confirmed by two-dimensional echocardiography and contrast ventriculography during cardiac catheterization. All of them had angiographically normal coronaries. The study was approved by the Institutional Ethics Committee, and all patients signed an informed consent form.Image acquisition and processing -Myocardial perfusion studies were performed at rest after an injection of thallium-201 (148 MBq) and, on the second day, MUGA-SPECT, after in vivo blood-pool labeling with injection of stannous chloride, followed by technetium-99m (740 MBq). Images were acquired using a dual-head digital gamma camera DST-SMV (Sopha Medical Vision -Twinsburg, Ohio, USA) equipped with a low-energy, high-resolution (LEHR) collimator with a 20% energy window centered at 70 KeV for thallium-201 images and at 140 KeV for technetium-99m images. ECG-gated SPECT studies were performed by acquiring 32 projections (60 seconds per projection) over a 180° semicircular orbit with the patient supine. Images were processed on a dedicated computer (Vision PowerStation -IBM -SMV), and tomographic slices were reconstructed and exported in a DICOM 3.0 format to a dedicated workstation with specific software for co-registration calculation.Image co-registration -The free software package VTK CISG Registration ToolKit (vtKCisg) 9 , which relies on registration algorithms based on similarity of voxel cross-correlation, was used. After image alignment, the insertion of the right ventricular myocardium into the interventricular septum was used as an anatomical landmark to check alignment accuracy. Whenever necessary, manual corrections were performed to improve alignment.

Multiple myeloma and Chagas disease: qPCR as a marker for preemptive antiparasitic therapy: a case reports series and review

“…In addition, outside the transplant setting, CDR has been described as single case reports in 12 patients from 1968 to 2015 (Table 5), more frequently in non-Hodgkin lymphoma and Hodgkin lymphoma [37][38][39][40][41][42][43][44][45][46][47][48] . Reactivation occurred during the induction phase or chemotherapy in the majority.…”

“…Reactivation occurred during the induction phase or chemotherapy in the majority. From these 12, seven received antiparasitic treatment with benznidazole or nifurtimox (Table 5), and only three survived after the end of the treatment 42,44,48 . The diagnosis was performed in three cases by necropsy 38,39,41 .…”

Exploring the Dimensions of Pre-Clinical Research: 3D Cultures as an Investigative Model of Cardiac Fibrosis in Chagas Disease

“…Cardiac remodeling with the formation of fibrotic and hypertrophic tissue seems to be the main contributor to the cardiomyopathy observed in patients [28][29][30]. The cardiac fibrotic being compromised can lead to myocardial infarction, heart failure and sudden death, resulting in poor outcomes [31,32].…”

Acidente vascular encefálico isquêmico em paciente com aneurisma apical: um relato de caso

“…Constituindo o mais notável dos distúrbios segmentares da cardiomiopatia chagásica crônica, embora não seja patognomônico dessa doença, o aneurisma apical consiste em um fator de risco independente para ocorrência do AVEi. Assim, a Doença de Chagas deve ser considerada enquanto hipótese como causa de tromboembolismo associado a evento cerebrovascular (Barbosa-Ferreira et al, 2010;Simões et al, 2007).…”