Myocardial Edema without Fibrosis by Magnetic Resonance T2 Mapping in Acute Chagas' Myocarditis

Sousa, Andréa Silvestre de; Derenne, Maria Eduarda; Hasslocher‐Moreno, Alejandro Marcel; Xavier, Sérgio Salles; Gottlieb, Ilan

doi:10.5935/abc.20170113

Cited by 4 publications

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“…It is important to emphasize that Souza et al (2017) observed only myocardial edema, without myocardial fibrosis, through cardiac resonance, but in only one subject with acute Chagas disease [30].…”

Section: Discussionmentioning

confidence: 96%

The Selvester QRS score as an estimative of myocardial injury in acute chagasic patients from the Brazilian Amazon

et al. 2021

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Background In the Brazilian Amazon, a new epidemiological profile of Chagas disease transmission, the oral route, has been detected and cited as being responsible for the increase in acute cases in Brazil. The clinical evaluation of acute Chagas disease (ACD) has been a challenge since it can progress to a chronic phase with cardiac alterations, and the follow-up by modern diagnostic methods is very difficult due to the socio-geographical characteristics of the Brazilian Amazon. Thus, alternatives should be sought to alleviate this problem. We conducted a study to evaluate subjects with ACD using the 12-lead ECG QRS score (Selvester score) as an estimative of myocardial injury progression before and after ACD treatment. Methods The study included indigenous subjects from the Amazon region with ACD in clinical follow-up at the Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD) Chagas Disease outpatient clinic in the state of Amazonas, Brazil. The control group consisted of 31 healthy volunteers with no history of heart disease and no reactive serology for Chagas disease. Baseline ECG was performed in all subjects. The Selvester scoring method was performed according to the standardized guide (< 3 points: no myocardial injury,> 3: points × 3% = % of the predicted LV infarction). Results A total of 62 subjects were included, 31 as cases and 31 as controls. The mean follow-up of the case group was 17 months. The control group presented normal ECG. The case group presented 13 alterations before treatment and 11 after. Nineteen individuals presented scores > 3 points, 6 before and 13 after. In 19.36% of subjects, myocardial injury was found before treatment and in 41.94% after treatment. Conclusion This is the first study that uses the Selvester score (SS) to predict myocardial injury in subjects with ACD. The results of this study suggest the significant presence of myocardial injury from the beginning of treatment to the period post treatment of ACD, which demonstrates that the SS can be applied for stratification and follow-up of Chagas disease in the Amazon region.

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Section: Discussionmentioning

confidence: 96%

The Selvester QRS score as an estimative of myocardial injury in acute chagasic patients from the Brazilian Amazon

et al. 2021

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“…A case of Chagas myocarditis in an adult patient reported that this technique helped diagnose myocarditis in the acute phase and over the follow-up period, showing progressive regression of the edematous myocardial areas in serial CMR tests. 54 The use of myocardial mapping in the chronic phase of Chagas disease is promising, as it may reveal subclinical changes and identify individuals at high risk of progressing to more advanced CCDC stages.…”

Section: Myocarditis Assessment Of Chagas Patientsmentioning

confidence: 99%

Myocardial Involvement in Chagas Disease: From the Perspective of Cardiovascular Magnetic Ressonance Assessment

Moreira¹,

Volpe²,

Schmidt³

2022

Arq Bras Cardiol: Imagem Cardiovasc

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Chagas disease represents an important public health problem, especially in endemic countries in Latin America. Chronic cardiomyopathy is its most frequent clinical presentation. Myocardial involvement has a multifactorial pathogenesis and can lead to heart failure, thromboembolic events, arrhythmias, and sudden death. In this context, cardiovascular magnetic resonance imaging (CMR) is an excellent noninvasive method for investigating myocardial damage and understanding the mechanisms and consequences of these injuries. CMR has high spatial resolution and tissue characterization capacity, enabling a highly reliable morphofunctional analysis and the identification of risk markers for adverse events in patients with Chagas disease. This exam is very useful for the diagnosis and follow-up of these patients in the routine clinical setting.

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“…Moreover, recent studies conducted in tertiary care centers have shown that late gadolinium enhancement analysis (LGE) can be used for optimal assessment of disease severity and can also act as a surrogate for prognosis in patients with overt Ch-CMP depending on the amount of scar found [113,[156][157][158][159][160]. For over 20 years, tissular edema identified both by traditional black blood imaging sequencing and more recently using T1 and T2 mapping, has also been described in Ch-CMP although its clinical application is still to be determined [161][162][163][164]. Nonetheless, an important limitation for CMR wide use of Ch-CMP evaluation is its availability in Latin America and the high costs it entails for healthcare systems when compared with TTE.…”

Section: Clinical Manifestations Diagnosis and Treatmentmentioning

confidence: 99%

Molecular and Clinical Aspects of Chronic Manifestations in Chagas Disease: A State-of-the-Art Review

et al. 2021

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Chronic manifestations of Chagas disease present as disabling and life-threatening conditions affecting mainly the cardiovascular and gastrointestinal systems. Although meaningful research has outlined the different molecular mechanisms underlying Trypanosoma cruzi’s infection and the host-parasite interactions that follow, prompt diagnosis and treatment remain a challenge, particularly in developing countries and also in those where the disease is considered non-endemic. This review intends to present an up-to-date review of the parasite’s life cycle, genetic diversity, virulence factors, and infective mechanisms, as well as the epidemiology, clinical presentation, diagnosis, and treatment options of the main chronic complications of Chagas disease.

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Myocardial Edema without Fibrosis by Magnetic Resonance T2 Mapping in Acute Chagas' Myocarditis

Cited by 4 publications

References 0 publications

The Selvester QRS score as an estimative of myocardial injury in acute chagasic patients from the Brazilian Amazon

The Selvester QRS score as an estimative of myocardial injury in acute chagasic patients from the Brazilian Amazon

Myocardial Involvement in Chagas Disease: From the Perspective of Cardiovascular Magnetic Ressonance Assessment

Molecular and Clinical Aspects of Chronic Manifestations in Chagas Disease: A State-of-the-Art Review

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