Discinergia ventricular esquerda reversível identificada por potenciação pós-extrassistólica em miocardiopatia chagásica crônica não é causada por hibernação miocárdica

Miziara, Andrea; Marin‐Neto, José Antônio; Marchini, Júlio Flávio Meirelles; Figueiredo, Geraldo L.; Pintya, Antonio Osvaldo; Simões, Marcus Vinı́cius; Antloga, C M

doi:10.1590/s2179-83972009000300014

Cited by 4 publications

(2 citation statements)

References 24 publications

(16 reference statements)

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“…The study was performed using post-extrasystolic potentiation, which is commonly observed during radiologicalcontrast left ventriculography, and showed that most myocardial areas with impaired wall motion indeed had a contractile reserve; that is, these areas were viable 59 . However, the hypothesis that hypokinetic areas of viable myocardium, unmasked through post-extrasystolic potentiation, would be predominant in regions exhibiting scintigraphic, reversible (ischemic) perfusion defects, was not confi rmed by the results of the study 60 .…”

Section: Pathophysiological Consequences Of Coronary Microvascular Pementioning

confidence: 80%

Pathogenesis of chronic Chagas cardiomyopathy: the role of coronary microvascular derangements

Marin-Neto

Simões

Rassi

2013

Rev. Soc. Bras. Med. Trop.

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There is ample experimental and clinical evidence of functional and structural microvascular abnormalities occurring in patients with Chagas cardiomyopathy, possibly due to the infl ammatory process and/or autonomic disturbances caused by Trypanosoma cruzi infection. Those microvascular derangements are likely to constitute at least an ancillary factor that potentiates and amplifi es the chronic infl ammation in myocardial tissue. It is possible to devise appropriate therapeutic interventions aimed at reverting or slowing the progression of the microvascular abnormalities to positively affect the natural history of Chagas cardiomyopathy.

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Section: Pathophysiological Consequences Of Coronary Microvascular Pementioning

confidence: 80%

Pathogenesis of chronic Chagas cardiomyopathy: the role of coronary microvascular derangements

Marin-Neto

Simões

Rassi

2013

Rev. Soc. Bras. Med. Trop.

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“…40,41 However, the hypothesis was not supported; the viability hidden by dyssynergia and shown through postextrasystolic potentiation could predominate or only appear in regions showing reversible perfusion defects during myocardial scintigraphy. 42 The second and perhaps most decisive mechanism would result in cellular death and consequent repairing fibrosis. In this context, there are relevant therapeutic implications potentially capable of attenuating, slowing, or even hindering the progression of myocardial dysfunction occasioned by ischaemic microcirculatory dysfunctions.…”

Section: Physiopathological Consequences and Opportunities For Therapmentioning

confidence: 99%

Base racional e plano de estudo prospectivo para avaliar o efeito de terapêutica antiplaquetária e vasodilatadora microcirculatória em pacientes com cardiopatia chagásica crônica e distúrbios microvasculares coronários

Macedo¹,

Lemos²,

Lago³

et al. 2012

Rev. Bras. Cardiol. Invasiva

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Background: Studies on Trypanosoma cruzi infections and histopathologic studies in individuals with Chagas disease suggest that ischaemia plays a role in the pathogenesis of myocardial lesions in the chronic phase of the disease. These ischaemic disorders are caused by microcirculatory deregulation. Atypical angina is a common symptom in patients in the chronic phase of Chagas disease. In a large number of patients, despite the absence of significant angiographic coronary obstructions, the occurrence of perfusion abnormalities is documented by myocardial scintigraphy during stress, which is reversible after rest. Methods: This will be a single-centre, prospective, single cohort study with a therapeutic intervention followed by a late quantitative re-evaluation of myocardial perfusion defects initially detected in patients with Chagas disease and angiographically normal coronary arte ries. Myocardial perfusion single-photon emission computed tomography (SPECT) will be performed before and 90 days after therapeutic intervention using Technetium ( 99m Tc) sestamibi as a radiotracer and physical stress or vasodilation stimulation with dipyridamole. Therapeutic intervention will consist of acetylsalicylic acid (single daily dose of 100 mg) with verapamil (80 mg b.i.d.; a total daily dose of 160 mg). The primary endpoint of the study is a > 50% reduction of the area of ischaemic myocardium calculated by the polar scintigraphic map. Conclusions: This will be the first study of a therapeutic approach to attenuate or reverse ischaemic

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Rationale and Design of a Prospective Study to Assess the Effect of Microcirculatory Antiplatelet and Vasodilation Therapy in Patients with Chronic Chagas Heart Disease and Coronary Microvascular Disease

Macedo

Conterno

Matos

et al. 2012

Revista Brasileira de Cardiologia Invasiva English Version

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Discinergia ventricular esquerda reversível identificada por potenciação pós-extrassistólica em miocardiopatia chagásica crônica não é causada por hibernação miocárdica

Abstract: A grafia discinergia (e suas variações) foi mantida conforme o original. Projeto parcialmente financiado pelo CNPq (Processo N o 520478/95-9) e pela FAPESP (Processo N o 1995/6195-8).

Cited by 4 publications

References 24 publications

Pathogenesis of chronic Chagas cardiomyopathy: the role of coronary microvascular derangements

Pathogenesis of chronic Chagas cardiomyopathy: the role of coronary microvascular derangements

Base racional e plano de estudo prospectivo para avaliar o efeito de terapêutica antiplaquetária e vasodilatadora microcirculatória em pacientes com cardiopatia chagásica crônica e distúrbios microvasculares coronários

Rationale and Design of a Prospective Study to Assess the Effect of Microcirculatory Antiplatelet and Vasodilation Therapy in Patients with Chronic Chagas Heart Disease and Coronary Microvascular Disease

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