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[Differences between patients with right bundle branch block and left anterior hemiblock in Chagas myocardiopathy]
R A Migliore1, F T Guerrero, M E Adaniya
1Servicio de Cardiología, Hospital Eva Perón, San Martín, Buenos Aires.
Insights
In Chagas disease, left anterior hemiblock (LAH) indicates more significant myocardial damage than complete right branch block (CRBB). Both conditions were assessed using EKG and echocardiography in a study of 25 patients.
Area of Science:
- Cardiology
- Electrophysiology
- Chagas disease research
Context:
- Chagas disease (Chd) can cause cardiac conduction abnormalities.
- Distinguishing the severity of myocardial damage associated with different blocks is crucial for patient management.
Purpose:
- To investigate whether specific conduction disturbances, namely complete right branch block (CRBB) and left anterior hemiblock (LAH), correlate with varying degrees of myocardial damage in Chagas disease patients.
Summary:
- A study involving 25 Chagas disease patients compared myocardial damage in groups with normal EKG, incomplete right branch block, and CRBB-LAH.
- Utilizing EKG, phonocardiogram, and echocardiography (M-mode, 2D, Doppler), researchers assessed systolic and diastolic functions, parietal motility, and arrhythmias.
- Left anterior hemiblock (LAH) was associated with more pronounced systolic/diastolic dysfunction, altered parietal motility, and malignant arrhythmias compared to CRBB.
Impact:
- Findings suggest that the presence of LAH in Chagas disease signifies greater myocardial damage than CRBB.
- This information can aid in risk stratification and treatment decisions for Chagas disease patients with cardiac conduction abnormalities.
Abstract:
In order to establish whether different kinds of conduction disturbances like complete right branch block (CRBB) and left anterior hemiblock (LAH) are associated with different degrees of myocardial damage in Chagas disease (Chd), we studied 25 patients (p), 15 males and 10 women (41 +/- 5 years old) who were divided into five groups: normal EKG 5 p, incomplete right branch block 5 p, CRBB-LAH 5 p. We performed EKG, phonocardiogram, echo-M, 2-D and Doppler. The systolic function was evaluated with velocity of circumferential shortening and Weissler index; parietal motility with score of motility; dilatation with diastolic diameter of left ventricle and diastolic function with isovolumetric relaxation time and E/A ratio mitral and tricuspid. The patients who did not present basal severe arrhythmias were submitted to stress testing. We found that in LAH there were great systolic and diastolic dysfunctions, parietal motility alterations and malignant arrhythmias as compared with CRBB. There was no significant difference between LAH and CRBB-LAH. In Chagas disease, the presence of LAH showed much more myocardial damage than in CRBB.