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Published on: July 20, 2022
Left Atrial Function in Patients with Chronic Chagasic Cardiomyopathy
Claudia da Silva Fragata1, Afonso Y Matsumoto2, Felix J A Ramires2
1Seção Médica de Eletrofisiologia, Instituto Dante Pazzanese de Cardiologia, São Paulo, BR.
Insights
Left atrial function is impaired in Chagas cardiomyopathy, particularly in patients with left ventricular dysfunction. Echocardiography reveals reduced reservoir, conduit, and pump functions, correlating with diastolic parameters.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Chagas Disease Research
Background:
- Chagas disease is a significant cause of dilated cardiomyopathy.
- Left atrial (LA) function in Chagas cardiomyopathy remains understudied.
Purpose of the Study:
- To evaluate reservoir, conduit, and pump functions of the left atrium.
- To correlate LA functions with left ventricular (LV) systolic and diastolic parameters in Chagas disease patients.
Main Methods:
- Echocardiographic assessment including M-mode, 2D, pulsed-wave Doppler, and tissue Doppler imaging.
- Study included 10 controls and 65 patients with Chagas disease categorized into indeterminate, ECG alteration, and LV dysfunction groups.
Main Results:
- Significant impairment of LA reservoir (Total Emptying Fraction), conduit (Passive Emptying Fraction), and pump (Active Emptying Fraction) functions observed in patients with LV dysfunction.
- Negative correlation found between E/e' and LA reservoir/pump functions; positive correlation between e' and LA reservoir, conduit, and pump functions.
Conclusions:
- Left atrial function is demonstrably impaired in Chagas cardiomyopathy.
- Echocardiographic parameters reflect the extent of LA dysfunction in this condition.
Background:
Chagas disease is a cause of dilated cardiomyopathy, and information about left atrial (LA) function in this disease still lacks.
Objective:
To assess the different LA functions (reservoir, conduit and pump functions) and their correlation with the echocardiographic parameters of left ventricular (LV) systolic and diastolic functions.
Methods:
10 control subjects (CG), and patients with Chagas disease as follows: 26 with the indeterminate form (GI); 30 with ECG alterations (GII); and 19 with LV dysfunction (GIII). All patients underwent M-mode and two-dimensional echocardiography, pulsed-wave Doppler and tissue Doppler imaging.
Results:
Reservoir function (Total Emptying Fraction: TEF): (p <0.0001), lower in GIII as compared to CG (p = 0.003), GI (p <0.001) and GII (p <0.001). Conduit function (Passive Emptying Fraction: PEF): (p = 0.004), lower in GIII (GIII and CG, p = 0.06; GI and GII, p = 0.06; and GII and GIII, p = 0.07). Pump function (Active Emptying Fraction: AEF): (p = 0.0001), lower in GIII as compared to CG (p = 0.05), GI (p<0.0001) and GII (p = 0.002). There was a negative correlation of E/e' (average) with the reservoir and pump functions (TEF and AEF), and a positive correlation of e' (average) with s' wave (both septal and lateral walls) and the reservoir, conduit and pump LA functions.
Conclusion:
An impairment of LA functions in Chagas cardiomyopathy was observed.
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