Left Atrial and Left Ventricular Diastolic Function in Chronic Chagas Disease

Nascimento, César A. S.; Gomes, Valmir; Silva, Sabrina K.; Santos, Carla Renata F.; Chambela, Mayara C.; Madeira, Fabiana S; Holanda, Marcelo Teixeira de; Brasil, Pedro Emmanuel Alvarenga Americano do; Sousa, Andréa Silvestre de; Xavier, Sérgio Salles; Hasslocher‐Moreno, Alejandro Marcel; Cunha, Ademir Batista da; Saraiva, Roberto Magalhães

doi:10.1016/j.echo.2013.08.018

Cited by 48 publications

(72 citation statements)

References 31 publications

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“…Previous studies have shown that LA strain was impaired in patients with both HFpEF and HFrEF [18][19][20][21][22]. It has been reported that LA strain is impaired in patients with diabetes and hypertension even if the size of the left atrium is normal (LA volume indexes < 28 ml/m 2 ) [23].…”

Section: Discussionmentioning

confidence: 99%

Left atrial strain in heart failure with preserved ejection fraction

Aung

Güler

et al. 2016

Herz

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Section: Discussionmentioning

confidence: 99%

Left atrial strain in heart failure with preserved ejection fraction

Aung

Güler

et al. 2016

Herz

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“…In addition to early detection of myocardial injury in ChD, strain has also been explored as a potential predictor of disease progression signaled by an increase in brain natriuretic peptide and worsening diastolic dysfunction. 62,63,65 Other uses of myocardial strain are currently being explored, such as for evaluation of mechanical dispersion (Figure 14), 66 as well as LA and RV strain. However, their use is currently experimental.…”

Section: Ivbiii Strain and Speckle-tracking Echocardiographymentioning

confidence: 99%

“…However, there are limited data to date on the additional value of 3D echocardiography for the evaluation of the left ventricle and left atrium in ChD. 65,99 Regardless of the parameter used to estimate ventricular systolic dysfunction, the most consistent independent risk predictor of mortality in ChD is impaired LV function. 39 In a systematic review, echocardiographic or cine ventriculographic evidence of decreased contractility, either qualitatively or quantitatively expressed, was found to be strongly associated with an increased risk for mortality in the majority of the studies reviewed.…”

Section: Va LV Systolic Functionmentioning

confidence: 99%

Recommendations for Multimodality Cardiac Imaging in Patients with Chagas Disease: A Report from the American Society of Echocardiography in Collaboration With the InterAmerican Association of Echocardiography (ECOSIAC) and the Cardiovascular Imaging Department of the Brazilian Society of Cardiology (DIC-SBC)

Acquatella

Asch

Barbosa

et al. 2018

Journal of the American Society of Echocardiography

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“…This marker could be able to differentiate progression among stages. Our findings are in agreement with Nascimento et al who demonstrated significant differences across severity stages of CCM in LV mass index. In contrast, Lima et al found no differences in 8 individuals with ChD indeterminate form, 13 CCM and 21 healthy controls in LV mass index.…”

Section: Discussionmentioning

confidence: 84%

Echocardiographic parameters, speckle tracking, and brain natriuretic peptide levels as indicators of progression of indeterminate stage to Chagas cardiomyopathy

et al. 2020

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Background Chronic Chagas cardiomyopathy (CCM) is characterized by a unique type of cardiac involvement. Few studies have characterized echocardiographic (Echo) transitions from the indeterminate Chagas disease (ChD) form to CCM. The objective of this study was to identify the best cutoffs in multiple Echo parameters, speckle tracking, and N‐terminal pro B‐type natriuretic peptide (NT‐proBNP) to distinguish patients without CCM (stage A) vs patients with myocardial involvement (stages B, C, or D). Methods Cross‐sectional study conducted in 273 consecutive patients with different CCM stages. Echo parameters, NT‐proBNP, and other clinical variables were measured. Logistic regression models (dichotomized in stage A versus B, C, and D) adjusted for age, sex, body mass index, and NT‐proBNP were performed. Results Left ventricular global longitudinal strain (LV‐GLS), mitral flow E velocity, LV mass index, and NT‐proBNP identified early changes that differentiated stages A vs B, C, and D. The LV‐GLS with a cutoff −20.5% showed the highest performance (AUC 92.99%; accuracy 84.56% and negative predictive value (NPV) 88.82%), which improved when it was additionally adjusted by NT‐proBNP with a cutoff −20.0% (AUC 94.30%; accuracy 88.42% and NPV 93.55%). Conclusions Our findings suggest that Echo parameters and NT‐proBNP may be used as diagnostic variables in detecting the onset of myocardial alterations in patients with the indeterminate stage of ChD. LV‐GLS was the more accurate measurement regarding stage A differentiation from the stages B, C, and D. Prospective longitudinal studies are needed to validate these findings.

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Left Atrial and Left Ventricular Diastolic Function in Chronic Chagas Disease

Cited by 48 publications

References 31 publications

Left atrial strain in heart failure with preserved ejection fraction

Left atrial strain in heart failure with preserved ejection fraction

Echocardiographic parameters, speckle tracking, and brain natriuretic peptide levels as indicators of progression of indeterminate stage to Chagas cardiomyopathy

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