Association between myocardial mechanical dispersion and ventricular arrhythmogenicity in chagas cardiomyopathy

Abstract

Endemic Chagas diseaseis a major health concernin LatinAmerica. Ventricular arrhythmias (VA) is a hallmark of Chagas cardiomyopathy (ChC) associated with worse prognosis. To verify if there is an association between myocardial mechanical dispersion and ventricular arrhythmogenicity in CCM. This is a cross-sectional study involving 77 patients with CCM. Global longitudinal strain (GLS) and MD were evaluated by echocardiogram, derived from the speckle tracking technique. Myocardial MD was measured from the onset of the Q / R wave on electrocardiogram to the peak longitudinal strain in 16 segments of the left ventricle. Frequency and complexity of ventricular extrasystoles (VES) were assessed by dynamic electrocardiography. The density and complexity of VES and the presence of non-sustained ventricular tachycardias (NSVTs) increase as MD increases. In logistic regression, MD was the only variable associated with the presence of VES in pairs and bigeminy. In the univariate analysis, both MD and GLS were associated with the presence of NSVT (both, p < 0.01), and MD was independently associated with NSVT (OR 1.04, 95% CI: 1.004-1.201, p = 0.031). In Chagas cardiomyopathy, MD is associated with a higher density and complexity of ventricular extrasystoles, including NSVT.

Association of Sympathetic Denervation, Myocardial Hypoperfusion, and Fibrosis with Ventricular Arrhythmias in Chronic Chagas Cardiomyopathy

“…GLS reflects the longitudinal deformation of the myocardium in a more sensitive and reproducible way than LVEF. 37,38 Azevedo et al 39 demonstrated a significant association between GLS and myocardial mechanical dispersion with nonsustained ventricular tachycardia in 77 patients with CCC. Recently, reductions in GLS were also observed in the undetermined form of the disease, before the onset of fibrosis.…”

Associação Entre Denervação Simpática, Hipoperfusão Miocárdica e Fibrose com as Arritmias Ventriculares na Cardiopatia Chagásica Crônica

“…O GLS reflete a deformação longitudinal do miocárdio de forma mais sensível e reprodutível do FEVE. 37,38 Azevedo et al 39 demonstraram uma associação significativa entre GLS e dispersão mecânica miocárdica com a taquicardia ventricular não sustentada em 77 pacientes com CCC. Recentemente, também foi observada a redução do GLS ainda na forma indeterminada da doença, antes do surgimento de fibrose.…”