Potenciação pós-extra-sistólica na cardiopatia chagásica crônica: estudo com ventriculografia de contraste radiológico

Brandão, José Mário Martins; Miziara, Andrea; Figueiredo, Geraldo Luiz de; Lima-Filho, M.O.; Ayres‐Neto, Elias Mello; Marin‐Neto, José Antônio

doi:10.1590/s0066-782x2005000500005

Cited by 5 publications

(4 citation statements)

References 28 publications

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“…Only one study directly addressed the question of hibernating myocardium in CCC. The study was performed using post-extrasystolic potentiation, which is commonly observed during radiologicalcontrast left ventriculography, and showed that most myocardial areas with impaired wall motion indeed had a contractile reserve; that is, these areas were viable 59 . However, the hypothesis that hypokinetic areas of viable myocardium, unmasked through post-extrasystolic potentiation, would be predominant in regions exhibiting scintigraphic, reversible (ischemic) perfusion defects, was not confi rmed by the results of the study 60 .…”

Section: Pathophysiological Consequences Of Coronary Microvascular Pementioning

confidence: 99%

Pathogenesis of chronic Chagas cardiomyopathy: the role of coronary microvascular derangements

Marin-Neto

Simões

Rassi

2013

Rev. Soc. Bras. Med. Trop.

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There is ample experimental and clinical evidence of functional and structural microvascular abnormalities occurring in patients with Chagas cardiomyopathy, possibly due to the infl ammatory process and/or autonomic disturbances caused by Trypanosoma cruzi infection. Those microvascular derangements are likely to constitute at least an ancillary factor that potentiates and amplifi es the chronic infl ammation in myocardial tissue. It is possible to devise appropriate therapeutic interventions aimed at reverting or slowing the progression of the microvascular abnormalities to positively affect the natural history of Chagas cardiomyopathy.

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Section: Pathophysiological Consequences Of Coronary Microvascular Pementioning

confidence: 99%

Pathogenesis of chronic Chagas cardiomyopathy: the role of coronary microvascular derangements

Marin-Neto

Simões

Rassi

2013

Rev. Soc. Bras. Med. Trop.

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“…The contrast ventriculography was then analysed according to a 9-segment model using a quantitation score that ascribed 1 to normal wall motion, 2 to hypokinesis, 3 to akinesia and 4 to dyskinesis. 20 An index of the global wall motion was obtained by summing the segmental scores divided by the number of segments analysed. 21 The ventriculogram also allowed the qualitative assessment of LV hypertrophy and dilation.…”

Section: Methodsmentioning

confidence: 99%

“…A ventriculografia de contraste foi então analisada de acordo com um modelo de 9 segmentos, utilizando um escore de quantificação que atribuiu 1 à mobilidade normal da parede, 2 à hipocinesia, 3 à acinesia e 4 à discinesia. 20 Um escore médio de movimentação segmentar da parede ventricular foi obtido pela soma das pontuações de cada segmento, dividida pelo número de segmentos analisados 21 conforme publicação recente de nossa instituição. O ventriculograma de contraste radiológico também permitiu a avaliação qualitativa de hipertrofia e dilatação do ventrículo esquerdo.…”

Section: Métodosunclassified

Estudo Comparativo da Doença Coronariana Microvascular Causada por Doença de Chagas e por Outras Etiologias

Campos¹,

Magalhães²,

Moreira³

et al. 2020

Arquivos Brasileiros De Cardiologia

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Fundamento: A doença de Chagas (DC) constitui uma causa potencial negligenciada de doença microvascular coronariana (DMC). Objetivos: Comparar pacientes com DMC relacionada à DC (DMC-DC) com pacientes com DMC ligada a outras etiologias (DMC-OE). Métodos: De 1292 pacientes estáveis, encaminhados para angiografia coronária invasiva para elucidar o padrão hemodinâmico e a causa de angina, 247 apresentaram coronárias subepicárdicas normais, e 101 foram incluídos após aplicação dos critérios de exclusão. Desses, 15 compuseram o grupo de DMC-DC e suas características clínicas, hemodinâmicas, angiográficas, e cintilográficas foram comparadas às do grupo de 86 pacientes com DMC-OE. O nível de significância estatística para todas as comparações adotado foi de 0,05. Resultados: Pacientes com suspeita de DMC-DC apresentaram características antropométricas, clínicas e angiográficas, além de alterações hemodinâmicas e de perfusão miocárdica estatisticamente comparáveis às detectadas nos 86 pacientes com DMC-OE. Disfunção ventricular diastólica, expressa por elevada pressão telediastólica do ventrículo esquerdo, foi igualmente encontrada nos dois grupos. Entretanto, em comparação a esse grupo com DMC-OE, o grupo com DMC-DC exibiu fração de ejeção ventricular esquerda mais baixa (61,

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“…That study, which used the postextrasystolic potentiation technique during radiologic-contrast cineventriculography, demonstrated that it was possible to identify contractile reserve in many dyssynergic areas; therefore, it is still a viable reserve. 40,41 However, the hypothesis was not supported; the viability hidden by dyssynergia and shown through postextrasystolic potentiation could predominate or only appear in regions showing reversible perfusion defects during myocardial scintigraphy. 42 The second and perhaps most decisive mechanism would result in cellular death and consequent repairing fibrosis.…”

Section: Physiopathological Consequences and Opportunities For Therapmentioning

confidence: 99%

Base racional e plano de estudo prospectivo para avaliar o efeito de terapêutica antiplaquetária e vasodilatadora microcirculatória em pacientes com cardiopatia chagásica crônica e distúrbios microvasculares coronários

Macedo¹,

Lemos²,

Lago³

et al. 2012

Rev. Bras. Cardiol. Invasiva

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Background: Studies on Trypanosoma cruzi infections and histopathologic studies in individuals with Chagas disease suggest that ischaemia plays a role in the pathogenesis of myocardial lesions in the chronic phase of the disease. These ischaemic disorders are caused by microcirculatory deregulation. Atypical angina is a common symptom in patients in the chronic phase of Chagas disease. In a large number of patients, despite the absence of significant angiographic coronary obstructions, the occurrence of perfusion abnormalities is documented by myocardial scintigraphy during stress, which is reversible after rest. Methods: This will be a single-centre, prospective, single cohort study with a therapeutic intervention followed by a late quantitative re-evaluation of myocardial perfusion defects initially detected in patients with Chagas disease and angiographically normal coronary arte ries. Myocardial perfusion single-photon emission computed tomography (SPECT) will be performed before and 90 days after therapeutic intervention using Technetium ( 99m Tc) sestamibi as a radiotracer and physical stress or vasodilation stimulation with dipyridamole. Therapeutic intervention will consist of acetylsalicylic acid (single daily dose of 100 mg) with verapamil (80 mg b.i.d.; a total daily dose of 160 mg). The primary endpoint of the study is a > 50% reduction of the area of ischaemic myocardium calculated by the polar scintigraphic map. Conclusions: This will be the first study of a therapeutic approach to attenuate or reverse ischaemic

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Potenciação pós-extra-sistólica na cardiopatia chagásica crônica: estudo com ventriculografia de contraste radiológico

Cited by 5 publications

References 28 publications

Pathogenesis of chronic Chagas cardiomyopathy: the role of coronary microvascular derangements

Pathogenesis of chronic Chagas cardiomyopathy: the role of coronary microvascular derangements

Estudo Comparativo da Doença Coronariana Microvascular Causada por Doença de Chagas e por Outras Etiologias

Base racional e plano de estudo prospectivo para avaliar o efeito de terapêutica antiplaquetária e vasodilatadora microcirculatória em pacientes com cardiopatia chagásica crônica e distúrbios microvasculares coronários

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