Assessment of left ventricular function in schistosomiasis

Area of Science:

• Cardiology
• Parasitology
• Internal Medicine

Background:

• Right ventricular changes in schistosomiasis are well-documented.
• Left ventricular involvement in schistosomiasis remains less understood.
• Potential mechanisms include shunts and toxic myocarditis.

Purpose of the Study:

• To assess left ventricular function in schistosomiasis.
• To investigate left ventricular changes across different stages of the disease.
• To utilize the rate of maximum rise of intraventricular pressure (dp/dt) as an index of contractility.

Main Methods:

• Studied 10 normal controls.
• Included 5 cases with bilharzial liver fibrosis (BLF) without ascites or cor pulmonale.
• Assessed 10 cases with BLF and ascites but no cor pulmonale.
• Evaluated 10 cases with bilharzial cor pulmonale.

Main Results:

• Diminished dp/dt values observed in 8/10 cases of bilharzial cor pulmonale, indicating defective left ventricular contractility.
• Left ventricular pressure curves in cor pulmonale cases showed distortion and delayed relaxation.
• Increased dp/dt values noted in BLF cases (with or without ascites), possibly due to elevated catecholamines.

Conclusions:

• The left ventricle is affected in schistosomiasis, especially in cases with bilharzial cor pulmonale.
• Defective contractility and potential diastolic volume overload occur in bilharzial cor pulmonale.
• BLF may lead to compensatory increases in left ventricular contractility.