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Published on: February 3, 2014
Imaging Diagnosis of Right Ventricle Involvement in Chagas Cardiomyopathy
Minna M D Romano1, Henrique T Moreira1, André Schmidt1
1Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
Insights
Right ventricle (RV) abnormalities are significant in Chagas disease (CD), but challenging to detect. Advanced cardiac imaging techniques like echocardiography and cardiac magnetic resonance (CMR) are improving the understanding of RV dysfunction in CD.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Tropical Diseases
Background:
- The right ventricle (RV) has been historically understudied, with its function primarily viewed through ventricular interdependence.
- Recent advancements have improved understanding of RV diseases, particularly in conditions like Chagas disease (CD).
- Chagas disease is known to cause significant structural abnormalities in the RV.
Purpose of the Study:
- To explore the pathophysiology of RV dysfunction in Chagas disease.
- To highlight the challenges and advancements in diagnosing RV abnormalities in CD patients.
- To discuss the role of evolving cardiac imaging techniques in assessing RV health.
Main Methods:
- Review of current knowledge on RV function and dysfunction in Chagas disease.
- Discussion of limitations in traditional echocardiography for RV assessment.
- Introduction of advanced echocardiographic techniques (focused guided RV imaging, myocardial deformation analysis).
- Emphasis on cardiac magnetic resonance (CMR) as a gold standard for RV volume assessment and tissue characterization.
Main Results:
- Clinical detection of RV abnormalities in CD is often limited by technical challenges in standard imaging tools.
- Echocardiography, while accessible, struggles with accurate RV geometrical representation.
- Cardiac magnetic resonance (CMR) offers precise quantitative analysis of RV volumes and detailed myocardium characterization (scar, edema).
Conclusions:
- Advanced cardiac imaging, including CMR and improved echocardiography, provides new avenues for investigating RV dysfunction in Chagas disease.
- Better diagnostic tools are crucial for understanding and managing the impact of CD on the right ventricle.
- Further research utilizing these techniques will enhance comprehension of RV pathophysiology in CD.
Abstract:
Right ventricle (RV) is considered a neglected chamber in cardiology and knowledge about its role in cardiac function was mostly focused on ventricular interdependence. However, progress on the understanding of myocardium diseases primarily involving the RV led to a better comprehension of its role in health and disease. In Chagas disease (CD), there is direct evidence from both basic and clinical research of profound structural RV abnormalities. However, clinical detection of these abnormalities is hindered by technical limitations of imaging diagnostic tools. Echocardiography has been a widespread and low-cost option for the study of patients with CD but, when applied to the RV assessment, faces difficulties such as the absence of a geometrical shape to represent this cavity. More recently, the technique has evolved to a focused guided RV imaging and myocardial deformation analysis. Also, cardiac magnetic resonance (CMR) has been introduced as a gold standard method to evaluate RV cavity volumes. CMR advantages include precise quantitative analyses of both LV and RV volumes and its ability to perform myocardium tissue characterization to identify areas of scar and edema. Evolution of these cardiac diagnostic techniques opened a new path to explore the pathophysiology of RV dysfunction in CD.
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