Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/31528
Title: Analysis of regional left ventricular strain in patients with Chagas disease and normal left ventricular systolic function
Authors: Gomes, Victor Augusto M.
Alves, Gabriel F.
Hadlich, Marcelo
Azevedo, Clerio F.
Pereira, Iane M.
Santos, Carla Renata F.
Brasil, Pedro Emmanuel A. A.
Sangenis, Luiz Henrique C.
Cunha, Ademir B.
Xavier, Sergio S.
Saraiva, Roberto M.
Affilliation: Instituto Nacional de Cardiologia. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Secretaria de Estado de Saúde do Estado do Rio de Janeiro. Centro Estadual de Diagnostico por Imagem. Rio de Janeiro, RJ, Brasil.
Secretaria de Estado de Saúde do Estado do Rio de Janeiro. Centro Estadual de Diagnostico por Imagem. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Instituto Nacional de Cardiologia. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Abstract: Background: Chagas heart disease has a high socioeconomic burden, and any strategy to detect early myocardial damage is welcome. Speckle-tracking echocardiography assesses global and segmental left ventricular (LV) systolic function, yielding values of two-dimensional strain (ε). The aim of this study was to determine if patients with chronic Chagas disease and normal LV ejectionfractions present abnormalities in global and segmental LVε. Methods: In this prospective study, patients with Chagas disease with no evidence of cardiac involvement (group I; n = 83) or at stage A of the cardiac form (i.e., with changes limited to the electrocardiogram) (group A; n = 42) and 43 control subjects (group C) underwent evaluation of global and segmental LV ε by speckletracking echocardiography. A subset of randomly selected patients in group A underwent cardiac magnetic resonance imaging and repeated echocardiography 3.5 6 0.8 years after the first evaluation. Results: Mean age, chamber dimensions, and LV ejection fraction were similar among the groups. Global longitudinal (group C, 19 6 2%; group I, 19 6 2%; group A, 19 6 2%), circumferential (group C, 19 6 3%; group I, 20 6 3%; group A, 19 6 3%), and radial (group C, 46 6 10%; group I, 45 6 13%; group A, 42 6 14%) LV ε were similar among the groups. Segmental longitudinal, circumferential, and radial LV ε were similar across the studied groups. Seven of 14 patients had areas of fibrosis on cardiac magnetic resonance imaging. Patients with fibrosis had lower global longitudinal ( 15 6 2% vs 18 6 2%, P = .004), circumferential ( 14 6 2% vs 19 6 2%, P = .002), and radial LV ε (36 6 13% vs 54 6 12%, P = .02) than those without cardiac fibrosis despite similar LV ejection fractions. Patients with fibrosis had lower radial LV ε in the basal inferoseptal wall than patients without cardiac fibrosis (27 6 17% vs 60 6 15%, P = .04). Conclusions: Patients with chronic Chagas disease and normal global and segmental LV systolic function on two-dimensional echocardiography had global and segmental LV ε similar to that of control subjects. However, those in the early stages of the cardiac form and cardiac fibrosis had lower global longitudinal, circumferential, and radial LV ε.
Keywords: Two-dimensional strain
Left ventricular systolic function
Chagas disease
Issue Date: 2016
Publisher: Elsevier
Citation: GOMES, Victor Augusto M. et al. Analysis of regional left ventricular strain in patients with Chagas disease and normal left ventricular systolic function. Journal of The American Society of Echocardiography, v. 29, n. 7, p. 679-688, July 2016.
DOI: 10.1016/j.echo.2016.03.007
ISSN: 0894-7317
Copyright: restricted access
Appears in Collections:INI - Artigos de Periódicos

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