Abstract
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. 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. 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. The indeterminate form of Chagas' disease can present cardiac wall motion abnormality, demonstrating functional and electric damage compared to chagasic patients with normal echocardiogram.
Highlights
Chagas’ disease can lead to severe and potentially lethal damage of cardiac function
O presente estudo demonstrou a existência de associação entre anormalidade contrátil e arritmia ventricular na forma indeterminada da doença de Chagas (FIDC), indicando que estes pacientes possam representar subgrupo com maior envolvimento cardíaco, e sendo a presença de anormalidade contrátil segmentar um substrato anatômico para o surgimento de um foco arrítmico, mesmo em um coração com função global preservada
Pacientes na forma indeterminada podem apresentar alterações morfológicas e funcionais com potencial significado prognóstico, sugerindo que apresentem comportamento diferenciado em relação àqueles pacientes que não apresentaram qualquer alteração morfofuncional cardíaca, mesmo quando submetidos à extensa avaliação
Summary
Chagas’ disease can lead to severe and potentially lethal damage of cardiac function. Embora esses pacientes não demonstrem redução significativa da função sistólica global ventricular, estudos prévios têm demonstrado evidência de anormalidade contrátil segmentar em indivíduos na forma indeterminada da doença de Chagas (FIDC), com evidência de prognóstico desfavorável comparativamente a pacientes que não apresentem dissinergia ventricular[3].
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