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Dysautonomia and ventricular dysfunction in the indeterminate form of Chagas disease

Roberta B G Molina1, Beatriz B Matsubara, João C Hueb

  • 1Departamento de Clínica Médica, Faculdade de Medicina de Botucatu-Universidade Estadual Paulista, UNESP, Brazil.

International Journal of Cardiology
|December 27, 2005
PubMed

Insights

Patients with indeterminate Chagas disease exhibit dysautonomia and left ventricular diastolic dysfunction, while right ventricular function remains preserved. These cardiac and autonomic issues are independent conditions.

Area of Science:

  • Cardiology
  • Autonomic Nervous System Research
  • Infectious Diseases

Background:

  • Chagas disease, caused by *Trypanosoma cruzi*, affects millions globally.
  • The indeterminate form of Chagas disease often presents without overt symptoms, making early detection challenging.
  • Understanding the interplay between autonomic function and biventricular performance is crucial for managing Chagas disease progression.

Purpose of the Study:

  • To investigate the relationship between autonomic function and biventricular function in patients with the indeterminate form of Chagas disease.
  • To assess cardiac autonomic neuropathy and its impact on right and left ventricular function.
  • To determine if cardiac dysfunction and autonomic dysfunction are linked in this patient population.

Main Methods:

  • Assessed autonomic function using 24-hour heart rate variability (HRV) time domain indices in 42 patients and 19 healthy volunteers.
  • Evaluated right ventricular function via fraction area change, right ventricle shortening, and systolic excursion of the tricuspid valve.
  • Assessed left ventricular function using ejection fraction and transmitral flow velocities, comparing results between groups using statistical tests and correlation analyses.

Main Results:

  • Left ventricular diastolic function was impaired in Chagas disease patients, indicated by decreased transmitral flow velocities.
  • Patients with indeterminate Chagas disease showed significantly impaired heart rate variability (HRV), suggesting dysautonomia.
  • Right and left ventricular systolic function remained comparable between patients and healthy controls, but no correlation was found between left ventricular diastolic indices and autonomic dysfunction.

Conclusions:

  • Indeterminate Chagas disease is associated with both dysautonomia and left ventricular diastolic dysfunction.
  • Right ventricular systolic function is preserved in the indeterminate form of Chagas disease.
  • Left ventricular diastolic dysfunction and dysautonomia in Chagas disease appear to be independent phenomena.
Abstract

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