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Relationship between microvascular changes, autonomic denervation, and myocardial fibrosis in Chagas cardiomyopathy:

Gustavo Canavaci Barizon1, Marcus Vinicius Simões2, André Schmidt2

  • 1Department of Computing and Mathematics, University of São Paulo, Av. Bandeirantes, 3900, Ribeirão Preto, SP, 14040-901, Brazil. gustavo.canavaci@usp.br.

Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology
|April 27, 2018
PubMed

Insights

Autonomic denervation, hypoperfusion, and fibrosis in Chagas cardiomyopathy are strongly correlated. Myocardial autonomic denervation may be a sensitive marker for cardiac involvement in Chagas disease.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Pathophysiology

Background:

  • The interplay between microvasculopathy, autonomic denervation, and myocardial fibrosis in Chagas cardiomyopathy remains unclear.
  • Understanding these relationships is crucial for diagnosing and managing the disease.

Purpose of the Study:

  • To investigate the extent and distribution of myocardial hypoperfusion, autonomic denervation, and scarring in Chagas cardiomyopathy.
  • To explore the correlation between these pathological features using advanced imaging techniques.

Main Methods:

  • Utilized Iodine-123-metaiodobenzylguanidine (MIBG) SPECT, 99mTc-Sestamibi (MIBI) rest-stress SPECT, and gadolinium late enhancement MRI in 13 Chagas disease patients.
  • Co-registered and quantified areas of denervation, hypoperfusion, and fibrosis using SPECT and MRI.

Main Results:

  • Demonstrated a strong anatomic concordance between hypoperfusion, denervation, and fibrosis.
  • Found a close association between myocardial denervation and stress-induced hypoperfusion.

Conclusions:

  • Combined analysis of autonomic denervation, hypoperfusion, and scarring aids understanding of Chagas cardiomyopathy pathophysiology.
  • Autonomic myocardial denervation may serve as a sensitive indicator of cardiac involvement in Chagas disease.
Abstract

Keywords:
Cardiac denervationCardiac imagingChagas diseaseMyocardial fibrosisMyocardial hypoperfusion

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