Value of cardiac MRI for evaluation of chronic Chagas disease cardiomyopathy
| Autor: | Salvador Hernandez, E.R. Felker, M. Thomas, M. Lee, Stephanie Lee-Felker, Sheba Meymandi, Mahmoud Traina, Mohsin Salih, Jason S. Bradfield |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Chagas Cardiomyopathy Male Chagas disease Adolescent 030231 tropical medicine 030204 cardiovascular system & hematology Risk Assessment Sensitivity and Specificity Young Adult 03 medical and health sciences 0302 clinical medicine Cardiac magnetic resonance imaging Prevalence medicine Humans Radiology Nuclear Medicine and imaging Wall motion Migrant population Chronic Chagas' Disease Cardiomyopathy Aged Ejection fraction medicine.diagnostic_test business.industry Reproducibility of Results Mean age General Medicine Middle Aged Prognosis medicine.disease Magnetic Resonance Imaging United States Population study Female Nuclear medicine business |
| Zdroj: | Clinical Radiology. 71:618.e1-618.e7 |
| ISSN: | 0009-9260 |
| DOI: | 10.1016/j.crad.2016.02.015 |
| Popis: | Aim To determine whether cardiac magnetic resonance imaging (cMRI) is more sensitive than electrocardiogram (ECG) and echocardiogram (ECHO) for detecting myocardial involvement in a Latin American migrant population with untreated Chagas disease (CD) in the United States. Materials and methods All untreated CD patients with ECG and ECHO examinations who underwent cMRI at Olive View-UCLA Medical Center from September 2010 to December 2013 ( n =81) were analysed in three groups: Group 1, normal ECG and ECHO examinations ( n =50); Group 2, abnormal ECG and normal ECHO examinations ( n =10); and Group 3, abnormal ECHO examination ( n =21). Frequencies of ECG, ECHO, and cMRI findings were compared across groups. Results Seventy percent (57/81) of the study population was female, with a mean age of 47 years (range, 17–77 years). Twenty-six percent (21/81) had delayed myocardial enhancement (DME), which was most commonly inferolateral in location (27%, 32/117 segments) and transmural in pattern (56%, 65/117 segments). Eight percent (4/50), 30% (3/10), and 67% (14/21) of Groups 1–3, respectively, had DME. Of these individuals with DME, 50% (2/4), 67% (2/3), and 100% (14/14) of Groups 1–3, respectively, also had wall motion abnormality (WMA) on cMRI. In addition to the highest percentages of DME and WMA, Group 3 also had significantly higher mean myocardial mass ( p 0.01), mean left ventricular end-diastolic ( p 0.01) and end-systolic volumes ( p 0.0005), and significantly lower mean left ventricular ejection fraction ( p 0.001). Conclusion cMRI may detect myocardial involvement in untreated CD that is otherwise unrecognised on ECG and ECHO. |
| Databáze: | OpenAIRE |
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