Disfunção miocárdica em pacientes chagásicos sem cardiopatia aparente

Pinto, Airandes de Sousa; Oliveira, Braulio; Botoni, Fernando Antônio; Ribeiro, Antônio Luiz Pinho; Rocha, Manoel Otávio da Costa

doi:10.1590/s0066-782x2007001800006

Cited by 8 publications

(3 citation statements)

References 28 publications

(20 reference statements)

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“…Pinto et al. 38 observed altered RMPI in 28% of Chagas patients without apparent heart disease in comparison with the control group (0.34 ± 0.10 versus 0.26 ± 0.07, p = 0.001) using PD 38 .…”

Section: Discussionmentioning

confidence: 96%

Right Ventricular Doppler Echocardiographic Study of Indeterminate Form of Chagas Disease

Furtado¹,

Rassi²,

Silva³

et al. 2014

Arquivos Brasileiros De Cardiologia

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BackgroundPatients with indeterminate form of Chagas disease/cardiac normality (ICD/CN) exhibited normal electrocardiograms and chest X-rays; however, more sophisticated tests detected some degree of morphological and functional changes in the heart.ObjectiveTo assess the prevalence of systolic and diastolic dysfunction of the right ventricle (RV) in patients with ICD/CN.MethodsThis was a case–control and prevalence study. Using Doppler two-dimensional echocardiography (2D), 92 patients were assessed and divided into two groups: group I (normal, n = 31) and group II (ICD/CN, n = 61).ResultsThe prevalence of RV systolic dysfunction in patients in groups I and II was as follows: fractional area change (0.0% versus 0.6%), mobility of the tricuspid annulus (0.0% versus 0.0%), and S-wave tissue Doppler (6.4% versus 26.0%, p = 0.016). The prevalence of global disorders such as the right myocardial performance index using tissue Doppler (16.1% versus 27.8%, p = 0.099) and pulsed Doppler (61.3% versus 68%, p = 0.141) and diastolic disorders such as abnormal relaxation (0.0% versus 6.0%), pseudonormal pattern (0.0% versus 0.0%), and restrictive pattern (0.0% versus 0.0%) was not statistically different between groups.ConclusionThe prevalence of RV systolic dysfunction was estimated to be 26% (S wave velocity compared with other variables), suggesting incipient changes in RV systolic function in the ICD/CN group.

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Section: Discussionmentioning

confidence: 96%

Right Ventricular Doppler Echocardiographic Study of Indeterminate Form of Chagas Disease

Furtado¹,

Rassi²,

Silva³

et al. 2014

Arquivos Brasileiros De Cardiologia

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“…Também é necessário reconhecer que o ECG normal, embora constitua critério definidor da FIDC, não é indicador fidedigno absoluto da ausência de acometimento cardíaco. Assim, quando se aprofunda a investigação com uso de outros métodos propedêuticos complementares, como o ECO, 312,313,[486][487][488][489] o teste de esforço ergométrico ou mesmo cardiopulmonar, 490,491 o Holter de 24 horas, 413,[492][493][494][495][496] as provas autonômicas não invasivas, 236,405,438,[497][498][499] a cintilografia cardíaca, 183,345,500,501 os estudos hemodinâmicos e cineangiográficos, 502 a RMC 311,453,503,504 e até mesmo a biópsia endomiocárdica, 505 com ECG normal apresenta anormalidades em alguns desses exames, muitas vezes de pequena monta ou baixa intensidade e frequência isolada.…”

Section: Condutas Terapêuticas Na Forma Indeterminada Da Doença De Ch...unclassified

Diretriz da SBC sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas – 2023

Marin-Neto¹,

Rassi²,

Oliveira³

et al. 2023

Arquivos Brasileiros De Cardiologia

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“…Generally, systolic and diastolic dysfunction coexist in Ch-CMP. Chronic myocarditis first alters ventricular relaxation and diastolic filling and, as the disease progresses, systolic dysfunction appears [ 79 ]. Patients usually may manifest with both left and right-sided heart failure, including symptoms such as fatigue, chest pain, dyspnea, pulmonary edema, increased jugular venous pressure, peripheral edema, ascites, and hepatomegaly.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Chagas Cardiomyopathy: From Romaña Sign to Heart Failure and Sudden Cardiac Death

et al. 2021

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Despite nearly a century of research and accounting for the highest disease burden of any parasitic disease in the Western Hemisphere, Chagas disease (CD) is still a challenging diagnosis, primarily due to its poor recognition outside of Latin America. Although initially considered endemic to Central and South America, globalization, urbanization, and increased migration have spread the disease worldwide in the last few years, making it a significant public health threat. The international medical community’s apparent lack of interest in this disease that was previously thought to be geographically restricted has delayed research on the complex host–parasite relationship that determines myocardial involvement and its differential behavior from other forms of cardiomyopathy, particularly regarding treatment strategies. Multiple cellular and molecular mechanisms that contribute to degenerative, inflammatory, and fibrotic myocardial responses have been identified and warrant further research to expand the therapeutic arsenal and impact the high burden attributed to CD. Altogether, cardiac dysautonomia, microvascular disturbances, parasite-mediated myocardial damage, and chronic immune-mediated injury are responsible for the disease’s clinical manifestations, ranging from asymptomatic disease to severe cardiac and gastrointestinal involvement. It is crucial for healthcare workers to better understand CD transmission and disease dynamics, including its behavior on both its acute and chronic phases, to make adequate and evidence-based decisions regarding the disease. This review aims to summarize the most recent information on the epidemiology, pathogenesis, clinical presentation, diagnosis, screening, and treatment of CD, emphasizing on Chagasic cardiomyopathy’s (Ch-CMP) clinical presentation and pathobiological mechanisms leading to sudden cardiac death.

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Disfunção miocárdica em pacientes chagásicos sem cardiopatia aparente

Abstract: SummaryBackground: The Tei index simultaneously evaluates the ventricular systolic and diastolic functions. It has a good correlation with hemodynamic data and has enabled the detection of initial ventricular function alterations of different etiologies.

Cited by 8 publications

References 28 publications

Right Ventricular Doppler Echocardiographic Study of Indeterminate Form of Chagas Disease

Right Ventricular Doppler Echocardiographic Study of Indeterminate Form of Chagas Disease

Diretriz da SBC sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas – 2023

Chagas Cardiomyopathy: From Romaña Sign to Heart Failure and Sudden Cardiac Death

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