Diastolic function in Chagas' disease: an echo and tissue Doppler imaging study

With the purpose of studying left ventricular filling in Chagas' disease (Chd), we evaluated 169 patients with Chd using echocardiography and Doppler and tissue Doppler imaging (TDI).

The patients were divided into four groups according to the pattern of left ventricular filling: Group 0--normal filling pattern, Group 1--abnormal relaxation, Group 2--pseudonormal flow pattern, and Group 3--restrictive pattern. All patients were submitted to TDI of the basal portion of the left ventricle's walls. Diastolic dysfunction was found in 21.3% of the patients, with a strong correlation between the worsening of diastolic function and ejection fraction (r = 0.78, P < 0.001). TDI septal e' wave measurement was the best method for the detection of any kind of diastolic dysfunction. Considering a cut-off point of 11 cm/s, a reduced e' wave value has 97% sensitivity, 84% specificity, 62% positive predictive value, and 99% negative predictive value. The septal E/e' ratio was the best index for the detection of advanced diastolic dysfunction. Considering a cut-point of 7.2, an elevated E/e' ratio has 100% sensitivity, 88% specificity, 54.2% positive predictive value, and 100% negative predictive value.

This study showed the characterization of the various patterns of left ventricle diastolic function by echocardiography and Doppler in Chagas' disease and the usefulness of TDI in the assessment of diagnosis of diastolic dysfunction in this disease.