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Echocardiographic Assessment of Cardiac Anatomy and Function in Adult Rats
Published on: December 13, 2019
Left atrial and left ventricular diastolic function in chronic Chagas disease
Cesar Augusto S Nascimento1, Victor Augusto M Gomes, Sabrina K Silva
1Instituto Nacional de Cardiologia, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
Summary
Left ventricular diastolic dysfunction is present in all stages of Chagas disease, impacting left atrial function and predicting clinical events. Early detection through diastolic function analysis is key for managing cardiac involvement.
Area of Science:
- Cardiology
- Echocardiography
- Chagas Disease Research
Background:
- Chagas disease can affect cardiac function, with early identification of cardiac involvement crucial for prognosis.
- Left atrial (LA) and left ventricular (LV) diastolic function analysis offers potential for early detection and risk stratification in Chagas disease.
Purpose of the Study:
- To evaluate left ventricular (LV) and left atrial (LA) diastolic function in patients with different stages of Chagas disease.
- To identify diastolic function parameters that predict clinical events in Chagas disease.
Main Methods:
- Prospective evaluation of 69 indeterminate and 143 cardiac Chagas disease patients, alongside 32 controls, using comprehensive echocardiography.
- Assessment included LV diastolic function (mitral inflow, pulmonary vein flow, tissue Doppler) and LA function (3D echo, strain analysis).
- Patients were followed for clinical events, with Cox regression analysis identifying independent predictors.
Main Results:
- Left ventricular (LV) diastolic dysfunction was progressively severe across Chagas disease stages, with Tissue Doppler E' velocity being a key indicator (P < .0001).
- Left atrial (LA) volume and conductive function were impaired in all cardiac forms, while contractile function was reduced only in heart failure stages.
- End-systolic LV diameter, E' velocity, and peak negative global LA strain were independent predictors of clinical events.
Conclusions:
- Left ventricular (LV) diastolic dysfunction is prevalent in all forms of Chagas disease, even without systolic dysfunction.
- LV diastolic dysfunction contributes to altered LA volume and conductive function in early cardiac Chagas disease.
- Both LV diastolic function and LA contractile function serve as independent predictors of clinical outcomes in Chagas disease.
Keywords:
2DCIChagas diseaseConfidence intervalELISAEnzyme-linked immunosorbent assayHFHeart failureLALVLeft atrialLeft atrial functionLeft ventricularLeft ventricular diastolic functionRT3DERVReal-time three-dimensional echocardiographyRight ventricularSTESpeckle-tracking echocardiographyStrainTwo-dimensionalTwo-dimensional strainVTIVelocity-time integralε
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