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

Autor: Gabriel Cordeiro Camargo, Mauro Felippe Felix Mediano, Renata Junqueira Moll-Bernardes, Martha Valéria Tavares Pinheiro, Clerio F. Azevedo, Fabio Paiva Rossini de Siqueira, Luiz Henrique Conde Sangenis, Marcelo Teixeira de Holanda, Andréa Silvestre de Sousa, Fernanda de Souza Nogueira Sardinha Mendes
Rok vydání: 2020
Předmět:
Chagas Cardiomyopathy
Male
Chagas disease
medicine.medical_specialty
030231 tropical medicine
Magnetic Resonance Imaging
Cine
Ventricular tachycardia
Sudden cardiac death
03 medical and health sciences
0302 clinical medicine
Fibrosis
Virology
Internal medicine
medicine
Humans
Chagas Disease
cardiovascular diseases
Aged
Ejection fraction
business.industry
Myocardium
Area under the curve
Heart
Stroke Volume
Organ Size
Articles
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Cross-Sectional Studies
Logistic Models
Infectious Diseases
ROC Curve
Echocardiography
Area Under Curve
Case-Control Studies
Electrocardiography
Ambulatory
Tachycardia
Ventricular
Ventricular Function
Right
cardiovascular system
Cardiology
Female
Parasitology
Myocardial fibrosis
Extracellular Space
Cardiac magnetic resonance
business
Zdroj: Am J Trop Med Hyg
ISSN: 1476-1645
0002-9637
DOI: 10.4269/ajtmh.20-0122
Popis: Chronic Chagas disease can progress to myocardial involvement with intense fibrosis, which may predispose patients to sudden cardiac death through ventricular arrhythmia. The associations of myocardial fibrosis detected by cardiac magnetic resonance (CMR) parameters with non-sustained ventricular tachycardia (NSVT) were evaluated. This cross-sectional study included patients in early stages of Chagas disease (n = 47) and a control group (n = 15). Patients underwent cardiac evaluation, including CMR examination. Myocardial fibrosis assessment by CMR with measurement of late gadolinium enhancement (LGE), native T1, and extracellular volume (ECV) was performed. There was an increase in myocardial fibrosis CMR parameters and ventricular arrhythmias among different stages of Chagas disease, combined with a decrease in the left ventricular ejection fraction (LVEF) by CMR and also in the right ventricular systolic function by S’ wave on tissue Doppler. Fibrosis mass and ECV were associated with the Rassi score, ventricular extrasystole, and E/e’ ratio in a logistic regression model adjusted for age and gender. The ECV maintained an association with the presence of NSVT, even after adjustments for fibrosis mass and LVEF assessed by CMR. The receiver-operating characteristic area under the curve for global ECV (0.85; 95% CI: 0.71–0.99) and NSVT was greater than that for fibrosis mass (0.75; 95% CI: 0.54–0.96), although this difference was not statistically significant. Extracellular volume could be an early marker of increased risk of ventricular arrhythmia in Chagas disease, presenting an independent association with NSVT in the initial stages of chronic Chagas cardiomyopathy, even after adjustment for fibrosis mass and LVEF.
Databáze: OpenAIRE
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