Abstract
Background: Chronic Chagas cardiomyopathy (CCM) is ranked among heart failure etiologies with the highest mortality rates. CCM is characterized by alterations in left ventricular function with a typical and unique pattern of myocardial involvement. Left ventricle longitudinal speckle tracking strain is emerging as an important additive method for evaluating left ventricular function and risk of future cardiovascular events. This systematic review aimed to characterize the left ventricle (LV) longitudinal strain by speckle tracking patterns in the different stages of Chagas disease, compared to healthy controls. Methods: Searches in Medline, EMBASE, and LILACS databases (from inception to 20 May 2021) were performed. Articles written in any language that assessed patients with Chagas disease and reported any measures derived from the left ventricular strain by speckle tracking were included. Two reviewers independently selected the studies, extracted the data, and assessed the quality of evidence. Standardized mean differences (SMD) were pooled using random-effects meta-analyses. Results: Of 1044 references, ten studies, including a total of 1222 participants (CCM: 477; indeterminate form: 444; healthy controls: 301), fulfilled the selection criteria and were included in the final analysis. Patients with CCM had a significantly higher mean global longitudinal strain (GLS) value than indeterminate form (IF) patients (SMD 1.253; 95% CI 0.53, 1.98. I2 = 94%), while no significant difference was observed between IF patients and healthy controls (SMD 0.197; 95% CI −0.19, 0.59. I2 = 80%). Segmental strain analyses revealed that patients with the IF form of CD had significantly worse strain values in the basal-inferoseptal (SMD 0.49; 95% CI 0.24, 0.74. I2: 24%), and mid-inferoseptal (SMD 0.28; 95% CI 0.05, 0.50. I2: 10%) segments compared to healthy controls. Conclusions: Our results suggest different levels of functional derangements in myocardial function across different stages of Chagas disease. Further research is needed to assess the prognostic role of LV longitudinal strain and other measures derived from speckle tracking in CD patients regarding progression to cardiomyopathy and clinical outcomes prediction.
Highlights
Chagas disease (CD) is an infectious disease caused by the protozoan parasite Trypanosoma cruzi (T. cruzi)
This period is called the indeterminate form (IF) of CD, which is characterized by the latency of the disease, and approximately 80% of the patients remain in this stage without exhibiting signs or symptoms of organ involvement [9]
From the total patients included in the metaysis, 477 (36.6%) had a serological confirmed diagnosis of CD, and evidence of myoca ipants were evaluated in the included studies
Summary
Chagas disease (CD) is an infectious disease caused by the protozoan parasite Trypanosoma cruzi (T. cruzi). The acute phase of this disease often goes underrecognized, as it is rarely severe; afterward, the chronic stage of the disease develops, in which the parasite persists in specific host tissues [6,7,8]. This period is called the indeterminate form (IF) of CD, which is characterized by the latency of the disease, and approximately 80% of the patients remain in this stage without exhibiting signs or symptoms of organ involvement [9]. CCM represents the most common form of chronic involvement, characterized by extensive arrhythmogenic and thrombogenic status, myocardial fibrosis, segmental wall motion abnormalities, and a dilated cardiomyopathy with rapidly progressive heart failure, all of which confer high morbidity and mortality [7,11]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
