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[Magnetic resonance imaging in chronic Chagas cardiopathy. Correlation with endomyocardial biopsy findings]

R Kalil1, E A Bocchi, B M Ferreira

  • 1Instituto do Coração do Hospital das Clínicas-FMUSP, São Paulo.

Arquivos Brasileiros De Cardiologia
|November 1, 1995
PubMed

Insights

Magnetic resonance imaging (MRI) can help diagnose myocarditis in Chagas' heart disease by showing increased signal intensity in the heart after gadolinium contrast. This imaging technique shows promise for identifying inflammation in Chagas' patients.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Infectious Diseases

Background:

  • Chagas' heart disease is a chronic condition often leading to heart failure.
  • Diagnosing active myocarditis in Chagas' disease can be challenging.
  • Endomyocardial biopsy is invasive and may not always reflect diffuse myocardial involvement.

Purpose of the Study:

  • To investigate the correlation between cardiac magnetic resonance imaging (CMR) findings and right ventricle endomyocardial biopsy (RVEMB) results in patients with chronic Chagas' heart disease.
  • To assess the utility of CMR with gadolinium enhancement in detecting myocardial inflammation in Chagas' heart disease.

Main Methods:

  • Ten male patients with Chagas' heart disease (mean age 47) in New York Heart Association functional classes II-IV underwent RVEMB and CMR.
  • A control group of patients with idiopathic dilated cardiomyopathy (mean age 46) was also studied for comparison.
  • Septal signal intensity on CMR after gadolinium contrast administration was quantitatively analyzed.

Main Results:

  • All Chagas' disease patients showed increased myocardial signal intensity on CMR after gadolinium, with significant septal signal change (0.87 to 1.54, p < 0.001).
  • RVEMB confirmed myocarditis in eight Chagas' patients and borderline myocarditis in two.
  • The control group showed no significant change in septal signal intensity after gadolinium (0.93 to 0.89, p = ns), with only one borderline myocarditis diagnosis.

Conclusions:

  • Myocarditis is a common finding in Chagas' heart disease.
  • Patients with Chagas' heart disease exhibit a significant increase in myocardial signal intensity post-gadolinium on CMR compared to controls.
  • Cardiac MRI appears to be a promising, non-invasive tool for diagnosing active inflammation in Chagas' heart disease.
Abstract

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