Doppler Tissue Imaging to Evaluate Early Myocardium Damage in Patients with Undetermined Form of Chagas' Disease and Normal Echocardiogram

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

doi:10.1046/j.1540-8175.2001.00131.x

Cited by 45 publications

(41 citation statements)

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“…Therefore, we can analyze quantitatively the characteristics of myocardial wall motility throughout the cardiac cycle, which enables a more accurate analysis of myocardial performance. Several studies have been conducted to validate the method in several pathological cardiac conditions, including Chagas' disease [20][21][22][23] .…”

Section: Discussionmentioning

confidence: 99%

Doppler tissue imaging to assess systolic function in Chagas' disease

Barros¹,

Ribeiro²,

Machado³

et al. 2003

Arq. Bras. Cardiol.

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Section: Discussionmentioning

confidence: 99%

Doppler tissue imaging to assess systolic function in Chagas' disease

Barros¹,

Ribeiro²,

Machado³

et al. 2003

Arq. Bras. Cardiol.

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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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“…The additional value of chest radiography in the initial assessment of patients with Chagas' disease and a normal electrocardiogram is questionable, because the examination has little sensitivity for detecting left ventricular dysfunction, the major indicator of risk in Chagas' disease. Currently, even echocardiography, although able to show abnormalities in segmentary contractility 24 or more subtle alterations on Doppler tissue imaging 25 , seems to have its routine use questionable in this population with an excellent prognosis. On the other hand, because individuals with typical electrocardiographic alterations may have either depressed or within the normal range left ventricular systolic function, additional examinations are indicated to identify the presence of left ventricular dysfunction.…”

Section: Discussionmentioning

confidence: 99%