Regional myocardial sympathetic denervation precedes the development of left ventricular systolic dysfunction in chronic Chagas' cardiomyopathy.

Autor: Gadioli LP; Division of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil., Miranda CH; Division of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil., Marin-Neto JA; Division of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil., Volpe GJ; Division of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil., Filho ACLB; Division of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil., Filho AP; Division of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil., Pintya AO; Division of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil., de Figueiredo AB; Division of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil., Simões MV; Division of Cardiology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil. msimoes@fmrp.usp.br.
Jazyk: angličtina
Zdroj: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology [J Nucl Cardiol] 2022 Dec; Vol. 29 (6), pp. 3166-3176. Date of Electronic Publication: 2022 Jan 04.
DOI: 10.1007/s12350-021-02869-3
Abstrakt: Background: Regional myocardial sympathetic denervation is a conspicuous and early disorder in patients with chronic Chagas' cardiomyopathy (CCC), potentially associated to the progression of myocardial dysfunction OBJECTIVE: To evaluate in a longitudinal study the association between the presence and the progression of regional myocardial sympathetic denervation with the deterioration of global and segmental left ventricular dysfunction in CCC.
Methods: 18 patients with CCC were submitted at initial evaluation and after 5.5 years to rest myocardial scintigraphy with 123 Iodo-metaiodobenzylguanidine and 99m Tc-sestamibi and to two-dimensional echocardiography to assess myocardial sympathetic denervation, extent of fibrosis, and the left ventricular ejection fraction (LVEF) and wall motion abnormalities.
Results: In the follow-up evaluation, compared to the initial one, we observed a significant decrease in LVEF (56 ± 11 to 49% ± 12; P = .01) and increased summed defects scores in the myocardial innervation scintigraphy (15 ± 10 to 20 ± 9; P < .01). The presence of regional myocardial sympathetic denervation in ventricular regions of viable non-fibrotic myocardium presented an odds ratio of 4.25 for the development of new wall motion abnormalities (P = .001).
Conclusion: Regional and global myocardial sympathetic denervation is a progressive derangement in CCC. In addition, the regional denervation is topographically associated with areas of future development of regional systolic dysfunction in patients with CCC.
(© 2022. The Author(s) under exclusive licence to American Society of Nuclear Cardiology.)
Databáze: MEDLINE
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