ABSTRACT
JUSTIFICATIVA E OBJETIVOS: A lesão apical (LA) é sede de tromboses e marcadora de mau prognóstico na doença de Chagas. O ecocardiograma bidimensional é um exame útil na avaliação de alterações morfofuncionais em cardiopatas chagásicos crônicos (CCC). O objetivo deste estudo foi avaliar a frequência da LA em CCC, diagnosticada por meio do ecocardiograma bidimensional com Doppler, e estudar clinicamente estes pacientes. MÉTODO: Realizou-se um estudo retrospectivo de prontuários de CCC submetidos ao ecocardiograma bidimensional com Doppler. Os pacientes foram divididos em dois grupos, na dependência da presença (Grupo A) ou ausência (Grupo B) da LA. Foram estudadas variáveis clínicas e ecocardiográficas, que foram submetidas à análise estatística.RESULTADOS: Foram incluídos 100 pacientes; 21 no grupo A [13-(61,9%) do sexo masculino; idade média de 61,10 anos] e 79 no B [46-(58,23 %) do sexo feminino; idade média de 57,01 anos]. Dos 50 pacientes miopatas, 70 batmopatas e 60 dromopatas observados, a LA esteve presente respectivamente em 17 (34,0%), 13 (18,6%) e 11 (18,3%). As três formas clínicas simultaneamente foram observadas em 26 pacientes, desses, sete (26,9%) apresentavam LA. A hipertensão arterial foi a comorbidade mais frequente, encontrada em 61 pacientes (61%), 11 (52,38%) eram do grupo A. No grupo B, 82,5% (52 pacientes) tinham fração de ejeção maior ou igual a 55, enquanto no grupo A, 26,3% (5 pacientes) a tinham abaixo de 55. Três casos de trombose foram diagnosticados ao Ecocardiograma; em dois o trombo se localizava na própria LA.(...)
BACKGROUND AND OBJECTIVES: The apical lesion (AL) is the seat of thrombosis and amarker of poor prognosis in Chagas disease. Bi-dimensional echocardiogram is a helpful tool in the evaluation of morphofunctional changes in chronic chagasic cardiopathy (CCC). The objective of this study was to evaluate the frequency of AL in CCC, diagnosed by bi-dimensional Doppler echocardiography and study these patients clinically. METHOD: A retrospective study of CCC medical records was conducted. The patients were submitted to a bi-dimensional Doppler echocardiogram and then divided into two groups, depending on the presence (Group A) or absence (Group B) of AL. We studied clinical and echocardiographic variables that were subjected to statistical analysis.RESULTS: 100 patients were included, 21 in group A [13 - (61.9%) males, average age 61.10 years old] and 79 in B [46 - (58.23%) females, average age 57.01 years old]. In this study we found 50 patients with myopathy, 70 with arrhythmias and 60 patients had intracardiac conduction disturbances. Among these patients, AL was present respectively in 17 (34.0%), 13 (18.6%) and 11 (18.3%). These three clinical forms were observed simultaneously in 26 patients and seven of them (26.9%) had AL. High blood pressure was the most common comorbidity which was found in 61 patients (61%); 11 (52.38%) of these patients had AL. In group B, 82.5% (52 patients) had an ejection fraction measured by echocardiography greater than or equal to 55; while in group A, 26.3% (5 patients) had an ejection fraction less than 55. Three cases of thrombosis were diagnosed by echocardiography; the thrombus was located in AL itself in two of these cases.(...)