Doppler tissue imaging to assess systolic function in Chagas' disease

Barros, Márcio Vinícius Lins; Ribeiro, Antônio Luiz Pinho; Machado, Fernando Santana; Rocha, Manoel Otávio da Costa

doi:10.1590/s0066-782x2003000100004

Cited by 23 publications

(25 citation statements)

References 18 publications

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“…Echodopplercardiographic features [19] and heart rate variability indices [9] of this population have been previously reported and other methodological aspects can be obtained in the cited articles. Patients underwent Doppler echocardiography with color flow using an ATL Philips HDI 5000 apparatus operated by an experienced ecocardiographer (M.V.L.B), blinded to the clinical status of the patients [19]. The left ventricular ejection fraction (LVEF) was obtained by Simpson's method using the software provided with the equipment.…”

Section: Study Protocolmentioning

confidence: 93%

Early occurrence of anti-muscarinic autoantibodies and abnormal vagal modulation in Chagas disease

Ribeiro

Giménez

Hernández

et al. 2007

International Journal of Cardiology

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Section: Study Protocolmentioning

confidence: 93%

Early occurrence of anti-muscarinic autoantibodies and abnormal vagal modulation in Chagas disease

Ribeiro

Giménez

Hernández

et al. 2007

International Journal of Cardiology

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“…With tissue Doppler imaging (TDI), 40 myocardial velocity systolic shortening and diastolic lengthening (EЈ and AЈ) during the cardiac cycle can be estimated (Figure 4). With TDI, subjects with normal ECGs and 2-dimensional echocardiograms have shown prolonged LV 41,42 and RV 43 isovolumic contraction times as signs of early contractile abnormalities. Thus, a normal ECG does not rule out myocardial abnormalities, the clinical significance of which is currently unknown.…”

Section: Systolic Functionmentioning

confidence: 99%

Echocardiography in Chagas Heart Disease

2007

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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.

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“…Estudos prévios publicados pelo nosso grupo têm demonstrado a superioridade desta técnica no diagnóstico de anormalidades funcionais precoces na doença de Chagas [11][12][13] .…”

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.

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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.

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Doppler tissue imaging to assess systolic function in Chagas' disease

Abstract: Objective -

Cited by 23 publications

References 18 publications

Early occurrence of anti-muscarinic autoantibodies and abnormal vagal modulation in Chagas disease

Early occurrence of anti-muscarinic autoantibodies and abnormal vagal modulation in Chagas disease

Echocardiography in Chagas Heart Disease

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

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