Cardiopatia chagásica crônica causando insuficiência cardíaca congestiva na infância: estudo clínico e histopatológico de um caso, com ênfase para as lesões dos sistemas excito-condutor e nervoso autônomo intracardíaco

Rocha, Ademir; Ja, da Cunha; Daud, Wan Suhana Wan; Ra, Heredia; Hb, Gomes; Mantese, O; Ac, da Fonseca Neto; Er, Lopes

doi:10.1590/s0037-86821993000400008

Cited by 3 publications

(1 citation statement)

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“…In paediatric patients with Chagas disease, clinical and echocardiographic alterations are infrequent, even in untreated patients. 28 A large retrospective study performed in Brazil that included all medical records obtained at a University Hospital between 1965 and 1984 and more than 18000 autopsies, revealed 19 Chagas disease patients under 18 years old with positive serology and findings compatible with chronic Chagasic heart disease. 29 In a seroepidemiological study performed in México, where more than 3000 untreated individuals younger than 18 years old living in a risk area were tested, Salazar-Schettino et al found 14 paediatric patients with septal and/or wall hypertrophy, ejection fraction below 57% and increased systolic pulmonary artery pressure.…”

Section: Discussionmentioning

confidence: 99%

Left ventricular longitudinal strain and strain rate measurements in paediatric patients in long-term treatment for Chagas disease

et al. 2021

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Introduction: Previous echocardiographic studies failed to show residual alterations of heart function in paediatric patients that have received treatment for Chagas disease. While the echocardiogram is the fundamental front-line tool for evaluating heart function, the appearance of new techniques allows a more detailed analysis. We aimed to evaluate systolic and diastolic function with new techniques in a paediatric population with Chagas disease several years after treatment completion. Material and methods: Echocardiograms were obtained from 84 Chagas disease patients (48 female) and 27 healthy controls. All patients had received treatment concluding on average 10 years prior to the study. The prospective analysis considered cardiac dimensions and cardiac function using two-dimensional, M-mode, Doppler and tissue Doppler imaging with emphasis on measuring longitudinal strain in the left ventricle by speckle tracking. Ejection fraction was measured with three-dimensional echocardiography. Results: Patients had an age of 14.2 ± 5.7 years (6–33) at the time of evaluation. Global and segmental motility of the left ventricle was normal in all patients. Ejection fraction was 59.2 ± 6.5 and 57.4 ± 6.5% (p = 0.31) in patients and controls respectively. Left ventricular global longitudinal systolic strain was −19 ± 2.4% in patients and −19 ± 3.6% (p = 0.91) in controls. No significant differences were found in remaining systolic and diastolic function measurements. Conclusions: Paediatric patients that have received treatment for Chagas disease, evaluated with either conventional techniques or new tools, do not show significant long-term alterations of ventricular function.

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Section: Discussionmentioning

confidence: 99%

Left ventricular longitudinal strain and strain rate measurements in paediatric patients in long-term treatment for Chagas disease

et al. 2021

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Chagas Disease as a Cause of Symptomatic Chronic Myocardopathy in Mexican Children

Salazar-Schettino¹,

Perera²,

Ruiz-Hernández³

et al. 2009

Pediatric Infectious Disease Journal

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We report the first case series of children in Mexico living with symptomatic Chagas disease causing chronic myocardopathy. The findings suggest that children with Chagas disease may develop symptomatic chronic myocardopathy earlier than previously recognized. Our findings emphasize the importance of longitudinal cardiologic follow-up of all children identified with acute Chagas disease.In a cohort of 826 children from the state of Queretaro in Mexico, 11 were identified with positive serology (ELISA and IFI) for Chagas and were tested for electrocardiogram alterations and symptoms and signs. Four children had ECG alterations with 3 of these reporting signs and symptoms associated with the chronic phase of Chagas disease (27%; 95% CI: 6%-61%). The most common chronic symptom was chest pain, with one child also reporting dyspnea and tachycardia.

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Cardiac plexus of dogs experimentally infected with Trypanosoma cruzi: inflammatory lesions and quantitative studies

Caliari¹,

Lana²,

Caliari³

et al. 1995

Rev. Soc. Bras. Med. Trop.

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Qualitative and quantitative aspects o f the superficial and profound cardiac plexus o f dogs experimentally infected with The pathogenesis of chagasic cardiopathy has been studied by several authors1211. Many factors seem to be involved: inflammation, autoimmunity, fibrosis and denervation18 19. For example, denervation has an important role in the pathology of the disease but is not always the main factor1314. Based on personal experience, mainly with dogs, although it has been found that chagasic cardiopathy is not counterbalanced in the acute and chronic phases, intense systematic lesions are not observed in the intracardial nervous system, mainly in its numerical reduction11.The aims of this paper are: a) to study the inflammatory phenomena, lesions and parasitism of the superficial and profound cardiac plexus of dogs experimentally infected with Be-62 and Be-78 strains of T. cruzi ', b) to carry out a quantitative study of ganglia and neuron bodies of these plexus in infected and control dogs. maintained in the laboratory, were used. Before inoculation, each animal was examined to exclude the possibility of prior T. cruzi infection. Two groups, each of four dogs, were inoculated intraperitoneally with 2000 blood trypomastigotes/ kg body weight, respectively, with Be-6217 and Be-7810 T. cruzi strains. Both strains were isolated, on different occasions, from Berenice, accepted to be the first known human patient of Chagas' disease6. Inocula were obtained from albino mice in the acute phase of infection and counted according to Brener (1962). Four normal dogs were used as controls. MATERIAL AND METHODSDogs were maintained on an ad libitum diet and observed daily. Parasitemia was assessed according to Brener4. Dogs were sacrificed about the 37th day of infection and necropsied. The atria were removed and fixed in totum in buffered formalin at pH 7.2, dehydrated, cleared and infiltrated with paraffin with the vessels in a basal position. Semi-serial sections (1:10), 4fim thick, were stained with HE and Gomori's thricromic.Ganglia were analysed in each section to determine the following aspects: inflammatory reactions, lesions and parasitism. Inflammation was classified as discreet (+ ), moderate (+ +) or intense (+ 4-+) according to the degree of cellular infiltration. Each ganglion and its neurons (normal and degenerated) were counted systematically. The number of neuron bodies per ganglia of infected dogs were compared with control dogs by Student "t" test.13

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Cardiopatia chagásica crônica causando insuficiência cardíaca congestiva na infância: estudo clínico e histopatológico de um caso, com ênfase para as lesões dos sistemas excito-condutor e nervoso autônomo intracardíaco

Cited by 3 publications

References 10 publications

Left ventricular longitudinal strain and strain rate measurements in paediatric patients in long-term treatment for Chagas disease

Left ventricular longitudinal strain and strain rate measurements in paediatric patients in long-term treatment for Chagas disease

Chagas Disease as a Cause of Symptomatic Chronic Myocardopathy in Mexican Children

Cardiac plexus of dogs experimentally infected with Trypanosoma cruzi: inflammatory lesions and quantitative studies

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