Echocardiographic parameters associated with pulmonary congestion in Chagas cardiomyopathy

Abstract

Introduction: Discrepancy between the intensity of pulmonary congestion and the grade of cardiomegaly seems to be a common finding of Chagas cardiomyopathy, in spite of significant systolic dysfunction of the left ventricle. Its mechanism has not been established. The aim of this study was to investigate pulmonary congestion and to analyze if it correlated with Doppler echocardiographic parameters in patients with Chagas dilated cardiomyopathy. Methods: Fifty-five patients with positive serology tests for Trypanosoma cruzi and Chagas dilated cardiomyopathy were studied. Chest x-rays, Doppler echocardiogram and plasmatic brain natriuretic peptide levels were obtained in all patients. The degree of pulmonary venous vessels changes on chest x-ray was graded using a pulmonary congestion score, and then compared to Doppler echocardiographic parameters. Results: Mean age was 48.5 ± 11.2 years and 29% were women. The majority (95%) of patients were in NYHA functional class I and II. Mild pulmonary congestion by chest x-ray was found in 80% of the patients. In a multivariate analysis, left ventricular ejection fraction, right ventricular TEI index and the color M-mode velocity correlated with the degree of pulmonary congestion. Conclusions: Pulmonary venous changes on chest x-rays are frequent, but usually mild in patients with Chagas dilated cardiomyopathy. The degree of pulmonary congestion correlates with Doppler echocardiographic left and right ventricular dysfunction and with color M-mode velocity.

Echocardiographic parameters associated with pulmonary congestion in outpatients with Chagas' cardiomyopathy and non-chagasic cardiomyopathy

“…In a previous study, we compared the degree of pulmonary congestion with echocardiographic parameters in CC. In that study, the degree of pulmonary congestion correlated with Doppler echocardiographic left and right ventricular dysfunction parameters 10 . Thus, the objective of the present study was to verify if CC presents with less pulmonary congestion when compared with non-CC (NCC) with the same echocardiographic characteristics.…”

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

“…O ECO transtorácico tornou-se, há décadas, importante instrumento no diagnóstico e acompanhamento dos pacientes com DC em suas diversas formas. 338 , 339 O ECO é o exame não invasivo mais utilizado na avaliação da função cardíaca por ser altamente disponível e confiável em sua obtenção e interpretação, além de ter custo relativamente baixo. O ECO permite determinar o estado evolutivo e as alterações mais sutis do comprometimento cardíaco, especialmente em fases menos avançadas da cardiomiopatia.…”

“…For decades, transthoracic ECHO has been an important tool for the diagnosis and follow-up of patients with the different forms of CD. 338 , 339 It is the most often used noninvasive test to assess cardiac function because of its wide availability and high reliability regarding performance and interpretation, as well as its relatively low cost. It enables determining the evolutionary status of the disease, as well as the most subtle cardiac impairment alterations, especially in the less advanced phases of cardiomyopathy.…”