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Associations between Cardiac Magnetic Resonance T1 Mapping Parameters and Ventricular Arrhythmia in Patients with

Martha Valéria Tavares Pinheiro1, Renata Junqueira Moll-Bernardes1, Gabriel Cordeiro Camargo1,2

  • 11D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil.

The American Journal of Tropical Medicine and Hygiene
|May 21, 2020
PubMed

Insights

In Chagas disease, increased myocardial fibrosis markers, like extracellular volume (ECV), are linked to ventricular arrhythmias. ECV shows an independent association with non-sustained ventricular tachycardia (NSVT), suggesting it may be an early risk indicator.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Infectious Diseases

Background:

  • Chronic Chagas disease can lead to heart damage, characterized by fibrosis and increased risk of sudden cardiac death due to ventricular arrhythmias.
  • Cardiac magnetic resonance (CMR) is a key tool for assessing myocardial fibrosis, a significant factor in Chagas cardiomyopathy progression.

Purpose of the Study:

  • To evaluate the association between myocardial fibrosis parameters measured by CMR and non-sustained ventricular tachycardia (NSVT) in patients with early-stage Chagas disease.
  • To determine if extracellular volume (ECV) is an independent predictor of ventricular arrhythmias in Chagas cardiomyopathy.

Main Methods:

  • A cross-sectional study involving 47 patients with early Chagas disease and 15 controls.
  • Cardiac evaluation included CMR to assess myocardial fibrosis using late gadolinium enhancement (LGE), native T1, and ECV.
  • Logistic regression analysis was used to identify associations between fibrosis markers, arrhythmias, and clinical scores.

Main Results:

  • Patients with Chagas disease showed increased myocardial fibrosis markers and ventricular arrhythmias compared to controls.
  • Extracellular volume (ECV) demonstrated an independent association with the presence of NSVT, even after adjusting for fibrosis mass and left ventricular ejection fraction (LVEF).
  • The area under the receiver-operating characteristic curve for global ECV in predicting NSVT was 0.85.

Conclusions:

  • Extracellular volume (ECV) measured by CMR may serve as an early marker for increased risk of ventricular arrhythmia in Chagas disease.
  • ECV shows an independent association with NSVT in the initial stages of chronic Chagas cardiomyopathy.
  • These findings highlight the potential of ECV as a prognostic indicator in managing Chagas cardiomyopathy.

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