Radionuclide esophageal transit scintigraphy in chronic indeterminate and cardiac forms of Chagas disease

Area of Science:

• Cardiology
• Gastroenterology
• Nuclear Medicine

Background:

• Chagas disease, caused by *Trypanosoma cruzi*, is known to affect the heart and digestive tract.
• Autonomic dysfunction is a suspected underlying mechanism in Chagas disease complications.
• Esophageal involvement is common in Chagas disease, but its direct association with cardiac function requires further investigation.

Purpose of the Study:

• To investigate the association between digestive and cardiac manifestations in Chagas disease.
• To evaluate esophageal transit using scintigraphy in patients with Chagas disease and healthy controls.
• To test the hypothesis that autonomic denervation in Chagas disease is a global process affecting both cardiac and digestive functions.

Main Methods:

• Esophageal transit scintigraphy was performed on 75 Chagas disease patients (33 indeterminate form, 42 dilated cardiac form) and 20 healthy controls.
• Esophageal transit time (ETT) and percentage of esophageal emptying (%EE) were analyzed.
• Correlation with left ventricular ejection fraction (LVEF) was assessed in the dilated cardiac form group.

Main Results:

• Esophageal transit alterations were observed in 57% of indeterminate and 80% of dilated cardiac form patients.
• ETT and %EE differed significantly between Chagas disease groups and controls (P<0.001).
• In dilated cardiac form patients, ETT and %EE significantly correlated with LVEF (r=0.398, P=0.015 and r=0.475, P=0.003, respectively).

Conclusions:

• Functional esophageal alterations are associated with left ventricular systolic dysfunction in Chagas disease.
• Findings suggest the concomitance of gastrointestinal and cardiac disorders, supporting a global autonomic denervation process.
• Greater impairment of esophageal autonomic function correlates with increased cardiac dysfunction severity.