Minor segmental dyssynergy reflects extensive myocardial damage and global left ventricle dysfunction in chronic Chagas disease

Almeida-Filho, Oswaldo C.; Maciel, Benedito Carlos; Schmidt, André; Pazin‐Filho, Antônio; Marin-Neto, José Antônio

doi:10.1067/mje.2002.117845

Cited by 26 publications

(21 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, since the risk of progression of these cases to the cardiac form, classically defined, appears to be higher than that of cases of Chagas disease without these changes, they should receive regular clinical follow-up (231) (232) .…”

Section: Chronic Chagas Cardiomyopathy Stagingmentioning

confidence: 99%

2 nd Brazilian Consensus on Chagas Disease, 2015

Dias

Ramos

Gontijo

et al. 2016

Rev. Soc. Bras. Med. Trop.

Self Cite

308

677

View full text Add to dashboard Cite

Section: Chronic Chagas Cardiomyopathy Stagingmentioning

confidence: 99%

2 nd Brazilian Consensus on Chagas Disease, 2015

Dias

Ramos

Gontijo

et al. 2016

Rev. Soc. Bras. Med. Trop.

Self Cite

308

677

View full text Add to dashboard Cite

“…The possible mechanisms are complex and may include ␤-adrenergic dysfunction, endothelial dysfunction, ischemia, and structural myocardial damage. 44 Others have shown a lower slope of the end-systolic pressure-dimension relation during phenylephrine infusion, 45 suggestive of a reduction in LV contractility in patients with the indeterminate form, mild cardiac involvement, or the digestive form of the disease. 45 RV systolic impairment may be the only abnormality detected by biventricular radionuclide angiography.…”

Section: Systolic Functionmentioning

confidence: 99%

“…44 Others have shown a lower slope of the end-systolic pressure-dimension relation during phenylephrine infusion, 45 suggestive of a reduction in LV contractility in patients with the indeterminate form, mild cardiac involvement, or the digestive form of the disease. 45 RV systolic impairment may be the only abnormality detected by biventricular radionuclide angiography. 46,47 In contrast, in a recent group of 74 patients studied by 2-dimensional and Doppler echocardiography, RV dysfunction, when present, was secondary to the severity of LV damage and high levels of pulmonary pressure rather than primary RV depressed function.…”

Section: Systolic Functionmentioning

confidence: 99%

Echocardiography in Chagas Heart Disease

2007

View full text Add to dashboard Cite

Background-Chagas heart disease is a frequent cause of morbidity and mortality in Latin America. Echocardiography provides useful diagnostic and prognostic information and is an important tool in the management of patients with Chagas disease. Methods and Results-A search for relevant publications was obtained from MEDLINE, LILACS, and SCIELO sources.Acute Chagas myocarditis is a rare disorder in which pericardial effusion is frequent. Echocardiography may exclude pericardial tamponade in case of heart failure. Chronic Chagas cardiomyopathy evolves for several decades after the infection. Epidemiological history, positive serology, and suggestive clinical and ECG abnormalities establish the diagnosis. About three quarters of chronic Chagas cardiomyopathy subjects remain asymptomatic with normal (indeterminate form) or abnormal ECGs. Early Doppler abnormalities includes prolongation of isovolumic contraction and relaxation times. Systolic function frequently is normal, but dysfunction may be elicited by stress tests. Half or more of symptomatic patients have a left ventricular apical aneurysm and other segmental contractile abnormalities similar to those seen in coronary heart disease. The dilated nonsegmental form is indistinguishable from dilated cardiomyopathy. Results from univariate and multivariate Cox survival analyses indicate that impaired systolic function and increased ventricular dimensions have significant value in predicting cardiac morbidity and mortality. Cardiac ultrasound commonly is used in the follow-up of patients and in the assessment of various therapeutic modalities. Conclusions-Echocardiographic and Doppler techniques provide useful structural and functional information in the detection of early myocardial damage, risk assessment of prognosis, disease progression, and management of patients with Chagas disease.

show abstract

“…Pacientes classificados na FIDC, mas apresentando alteração contrátil segmentar ao ecocardigrama, apresentam sinais de diminuição global da contratilidade ventricular esquerda. Além disso, independente da classificação clínica, pacientes com alteração contrátil ao ecocardiograma demonstram sinais de depressão maior da contratilidade miocárdica, quando comparados com pacientes que apresentam apenas distúrbios isolados da condução elétrica ao ECG 8 .…”

Section: Discussionunclassified

Associação entre dissinergia miocárdica e arritmia ventricular na forma indeterminada da doença de Chagas

Barros

Ribeiro

Nunes

et al. 2011

Rev. Soc. Bras. Med. Trop.

View full text Add to dashboard Cite

RESUMOIntrodução: Pacientes na forma indeterminada da doença de Chagas (FIDC) podem apresentar anormalidades contráteis segmentares, com evidências de pior prognóstico comparativamente a pacientes com estudo ecocardiográfico normal. O objetivo deste estudo foi de avaliar a associação entre a presença de anormalidade contrátil segmentar e a presença de distúrbios do ritmo cardíaco na FIDC. Métodos: Foram estudados 38 pacientes na FIDC, sendo 26 pacientes sem anormalidade contrátil e 12 com presença de distúrbio contrátil ao estudo ecocardiográfico. Todos os pacientes foram submetidos a um estudo ecocardiográfico completo, incluindo o Doppler tecidual, bem como à monitorização eletrocardiográfica de 24h (Holter). Resultados: Entre as diversas variáveis estudadas, foram encontradas diferenças significativas entre os dois grupos em relação à fração de ejeção (p ≤ 0,001), dimensão sistólica do ventrículo esquerdo (p = 0,029) e tempo de contração isovolumétrica (p < 0,05) medidos pela ecocardiografia e Doppler tecidual, bem como extrassistolia ventricular isolada (p = 0,016) e em pares (p = 0,003) pela avaliação pelo Holter. Conclusões: Pacientes na FIDC que apresentam anormalidades contráteis quando avaliados pela ecocardiografia apresentam episódios mais frequentes de extrassistolia ventricular, traduzindo um maior dano morfofuncional e elétrico do coração, quando comparados a pacientes que apresentem estudo ecocardiográfico normal. Palavras-chaves: Doença de Chagas. Ecocardiografia. Arritmia ventricular. ABSTRACTIntroduction: Chagas' disease can lead to severe and potentially lethal damage of cardiac function. Thus, the identification of cardiac abnormalities in patients presenting the indeterminate form (IF) can be important for risk stratification. This paper aimed to demonstrate whether IF chagasic patients who presented wall motion abnormalities showed functional and electric disturbances compared to patients with normal echocardiogram and Doppler studies. Methods: Thirty eight patients with the IF were studied, including 26 chagasic patients with normal electrocardiographic, radiological and echocardiographic exams and 12 chagasic patients showing segmental wall motion abnormalities in the echocardiographic exam. All the patients were submitted to complete echocardiogram and Doppler study, including tissue Doppler imaging (TDI) and Holter 24h monitoring. Results: Among the variables evaluated, significant differences among the two groups were verified in relation to: the ejection fraction (p ≤ 0.001); left ventricular systolic dimension (p = 0.029); isovolumic contraction time, measured by TDI in the basal segments of the left ventricle (p < 0.05); and the presence of isolated (p = 0.0005) and paired ventricular extrasystoles (p = 0.003), in the Holter monitoring. Conclusions: The indeterminate form of Chagas' disease can present cardiac wall motion abnormality, demonstrating functional and electric damage compared to chagasic patients with normal echocardiogram.

show abstract

Minor segmental dyssynergy reflects extensive myocardial damage and global left ventricle dysfunction in chronic Chagas disease

Cited by 26 publications

References 17 publications

2 nd Brazilian Consensus on Chagas Disease, 2015

2 nd Brazilian Consensus on Chagas Disease, 2015

Echocardiography in Chagas Heart Disease

Associação entre dissinergia miocárdica e arritmia ventricular na forma indeterminada da doença de Chagas

Contact Info

Product

Resources

About