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[Maximal functional capacity and diastolic function in patients with cardiomyopathy due to Chagas' disease without
Insights
Early cardiac dysfunction in Chagas disease patients may involve impaired systolic and diastolic ventricular function, even before symptoms appear. This study identified key differences in functional capacity and diastolic parameters in asymptomatic individuals with Chagas cardiomyopathy.
Area of Science:
- Cardiology
- Infectious Diseases
- Physiology
Context:
- Chagas' cardiomyopathy is a significant public health concern, often progressing silently.
- Early detection of cardiac dysfunction is crucial for timely intervention.
- Asymptomatic patients with Chagas disease may harbor subclinical cardiac abnormalities.
Purpose:
- To identify early cardiac dysfunctions in asymptomatic individuals with Chagas' cardiomyopathy.
- To compare functional capacity and left ventricular diastolic function between Chagas patients and healthy controls.
Summary:
- This study evaluated 38 male individuals (18 Chagas patients, 20 controls) using cardiopulmonary exercise testing and echocardiography.
- Asymptomatic Chagas patients showed significant differences in maximal O2 consumption (VO2max), O2-pulse rate (PO2max), maximal ventilation (VEmax), maximal heart rate (HRmax), anaerobic threshold (VO2-AT), and E/A ratio compared to controls.
- No significant differences were found in fractional shortening (FS) or A wave, suggesting preserved systolic function but altered diastolic function.
Impact:
- Findings suggest that impaired ventricular function, encompassing both systolic and diastolic aspects, contributes to early cardiac changes in Chagas' cardiomyopathy.
- This research aids in understanding the pathophysiology of early-stage Chagas heart disease.
- Highlights the potential for non-invasive methods to detect early cardiac dysfunction in Chagas patients.
Purpose:
To identify early cardiac dysfunctions in asymptomatic patients with Chagas' cardiomyopathy.
Methods:
We studied 38 male individuals: control group consisting of 20 sedentary normal individuals and Chagas' group, of 18 asymptomatic patients with Chagas' disease, with suggestive electrocardiographic alterations and normal fractional shortening (FS) on echocardiogram. Both groups were submitted to evaluation of the maximal functional capacity, with measurements of maximal O2 consumption (VO2max), O2-pulse rate (PO2max), maximal ventilation (VEmax), maximal heart rate (HRmax), and anaerobic threshold of the VO2max (VO2-AT). Left ventricular diastolic function was evaluated by conventional echocardiography (E wave, A wave and E/A ratio).
Results:
No significant differences occurred between the two groups with regard to FS (p = 0.212) and age means (p = 0.060). The 2 groups were significantly different (p < 0.001) regarding the parameters VO2max, PO2max, VEmax, HRmax and VO2-AT, E wave and E/A ratio. There was no difference (p = 0.520) in A wave.
Conclusion:
Impaired ventricular function may account for the above mentioned differences, a consequence of both systolic and diastolic dysfunctions.