Use of tissue doppler imaging for the early detection of myocardial dysfunction in patients with the indeterminate form of Chagas disease

Abstract INTRODUCTION: Chagas disease is one of the most common diseases in Latin America and heart involvement is the main cause of death. This study aimed to determine differences in tissue Doppler imaging (TDI) parameters in the assessment left and right ventricular function in patients with the indeterminate form of Chagas disease compared to those in healthy controls. METHODS: We compared 194 patients with the indeterminate form of Chagas disease to 72 age-matched healthy individuals. We considered p-values <0.05 to be statistically significant. RESULTS: TDI analysis of the right ventricular (RV) showed lengthened isovolumic relaxation time (IRT) and higher RV index of myocardial performance (RIMP) and left ventricle (LV) index of myocardial performance (LIMP) in the Chagas group than in the control group, indicating RV and LV systolic and diastolic myocardial damage. TDI analysis of the myocardial velocities of the interventricular septum and the lateral wall of the LV also showed a systolic and diastolic myocardial damage. CONCLUSIONS: The study results demonstrated early LV systolic and diastolic myocardial damage in the RV and LV in patients with the indeterminate form of Chagas disease by TDI. These early findings of RV and LV dysfunction may help identify patients who will progress to heart failure during the disease course. TDI should be included in initial patient evaluations because it allows adequate follow-up and treatment.

Ventrículo izquierdo no compactado y enfermedad coronaria significativa: una asociación poco frecuente / Severe coronary artery disease and left ventricular noncompaction: a rare association

Se presenta el caso de un varón de 56 años, dislipémico, tabaquista, con antecedentes heredofamiliares e historia de angina crónica estable en clase funcional II de 20 años de evolución. Consulta por episodio de angina progresiva. Se realizó ecocardiograma Doppler transtorácico en el que se observó ventrículo izquierdo no compactado con deterioro severo de la función sistólica y el estudio de perfusión gated SPECT demostró viabilidad anteroseptal. Presentaba lesión significativa de tres vasos y se realizó cirugía de revascularización miocárdica. A un año del procedimiento persiste el deterioro severo de la función sistólica y permanece totalmente asintomático.