[Apical lesions in Chagas' heart disease patients: an autopsy study]

Cristina Brandt Friedrich Martin Gurgel1, Maria Cristina Furian Ferreira, Clayde Regina Mendes

  • 1Centro de Ciências da Vida, Faculdade de Medicina, Pontifícia Universidade Católica, Campinas, SP. cbfmgurgel@ig.com.br

Insights

Apical ventricular lesions in Chagas

Area of Science:

  • Cardiology
  • Pathology
  • Chagas' Disease Research

Background:

  • Apical ventricular lesions are linked to increased risk of intracardiac thrombosis and thromboembolic events.
  • Chagas' heart disease (ChHD) is a significant cause of morbidity and mortality worldwide.
  • Understanding the relationship between apical lesions and thrombosis in ChHD is crucial for patient management.

Purpose of the Study:

  • To evaluate the incidence of apical lesions in Chagas' heart disease patients.
  • To determine the association between apical lesions and intracardiac thrombosis in ChHD.
  • To compare clinical and autopsy findings in ChHD patients with and without apical lesions.

Main Methods:

  • Retrospective autopsy review of 51 Chagas' heart disease patients.
  • Statistical comparison of clinical variables and autopsy findings between patients with (Group A) and without (Group B) apical lesions.
  • Analysis included heart weight, presence of arrhythmias, and incidence of thrombosis.

Main Results:

  • Apical lesions were found in 80% of the left ventricles studied.
  • Thrombosis occurred in 60% of patients with apical lesions, with 53.3% of thrombi located within the lesion.
  • Patients with apical lesions had significantly higher mean heart weight (500.9g vs 408.4g) and a higher incidence of cardiac arrhythmias.

Conclusions:

  • Apical ventricular lesions are common in Chagas' heart disease and strongly associated with intracardiac thrombosis.
  • Higher heart weight and increased incidence of arrhythmias are key indicators in patients with apical lesions and thrombosis.
  • Myopathy, indicated by heart weight >500g, is a primary factor for thrombosis in ChHD patients.
Abstract

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