Use of tissue doppler imaging for the early detection of myocardial dysfunction in patients with the indeterminate form of Chagas disease

Abstract

Introduction: Chagas disease is one of the most common diseases in Latin America and heart involvement is the main cause of death. This study aimed to determine differences in tissue Doppler imaging (TDI) parameters in the assessment left and right ventricular function in patients with the indeterminate form of Chagas disease compared to those in healthy controls. Methods: We compared 194 patients with the indeterminate form of Chagas disease to 72 age-matched healthy individuals. We considered p-values <0.05 to be statistically significant. Results: TDI analysis of the right ventricular (RV) showed lengthened isovolumic relaxation time (IRT) and higher RV index of myocardial performance (RIMP) and left ventricle (LV) index of myocardial performance (LIMP) in the Chagas group than in the control group, indicating RV and LV systolic and diastolic myocardial damage. TDI analysis of the myocardial velocities of the interventricular septum and the lateral wall of the LV also showed a systolic and diastolic myocardial damage. Conclusions: The study results demonstrated early LV systolic and diastolic myocardial damage in the RV and LV in patients with the indeterminate form of Chagas disease by TDI. These early findings of RV and LV dysfunction may help identify patients who will progress to heart failure during the disease course. TDI should be included in initial patient evaluations because it allows adequate follow-up and treatment.

New Biomarker in Chagas Disease: Extracellular Vesicles Isolated from Peripheral Blood in Chronic Chagas Disease Patients Modulate the Human Immune Response

“…This combination approach is due to the reduced specificity of the tests based on the type of antigen used, which may lead to cross-reactivity with other parasitic diseases such as leishmaniasis [ 7 ]. There are still no available methodologies for the prognosis of confirmed chronic patients, although some studies using molecular and imaging approaches have shown some degree of correlation with the disease severity [ 8 – 10 ].…”

Speckle tracking echocardiography in the indeterminate form of Chagas disease

“…Two‐dimensional echocardiography is a very sensitive echocardiographic tool for detecting early systolic and diastolic dysfunction in several heart diseases and in assessing left ventricular (LV) filling pressures 10–12 . The major predictor of mortality and morbidity in patients with chronic ChD is LV systolic dysfunction, and the prognosis is very poor once heart failure occurs 3,11–18 …”

“…Two-dimensional echocardiography is a very sensitive echocardiographic tool for detecting early systolic and diastolic dysfunction in several heart diseases and in assessing left ventricular (LV) filling pressures. [10][11][12] The major predictor of mortality and morbidity in patients with chronic ChD is LV systolic dysfunction, and the prognosis is very poor once heart failure occurs. 3,[11][12][13][14][15][16][17][18] Two-dimensional speckle tracking echocardiography strain allows ventricular quantitative segmental analysis, overcoming the subjective evaluation of LV regional systolic function by conventional two-dimensional echocardiography.…”

“…[10][11][12] The major predictor of mortality and morbidity in patients with chronic ChD is LV systolic dysfunction, and the prognosis is very poor once heart failure occurs. 3,[11][12][13][14][15][16][17][18] Two-dimensional speckle tracking echocardiography strain allows ventricular quantitative segmental analysis, overcoming the subjective evaluation of LV regional systolic function by conventional two-dimensional echocardiography. 18 Consequently, the early detection of myocardial damage is essential if appropriate treatment is to be offered to patients with ChD, thus improving their quality of life and life expectancy.…”

Clinical significance of tissue Doppler imaging in chronic Chagas disease

“…Doppler tissue imaging (DTI) is a very sensitive echocardiographic tool for detecting systolic and diastolic dysfunction of both ventricles in several heart diseases and in assessing left ventricular (LV) filling pressures 10–12 . The major predictor of mortality and morbidity in patients with ChD is LV systolic dysfunction, and the prognosis is very poor once heart failure occurs 3,8,11–16 . Consequently, the early detection of myocardial damage 17 is essential if appropriate treatment is to be offered to patients with ChD, thus improving their quality of life and life expectancy.…”