CMR reveals myocardial injury in patients with Chagas disease for first time
Brazil: For the first time, the researchers in a study published in the Journal of the American Heart Association, have described myocardial injury shown by cardiovascular magnetic resonance imaging in a group of patients with acute Chagas disease. The study reveals the importance of early detection and follow-up of cardiac impairment in patients with acute Chagas disease.
Chagas disease is a neglected tropical disease that is considered a global health emergency. Most of the reports in the Amazon regions are of acute cases that are associated with oral transmission. João Marcos Bemfica Barbosa Ferreira, Universidade Nilton Lins, Manaus, Amazonas, Brazil, and colleagues aimed to investigate myocardial injury in patients with acute Chagas disease before and after treatment.
For this purpose, the researchers evaluated 23 patients with acute Chagas disease in 3 different stages of progression. Group 1 had 12 patients evaluated during the acute phase, at the time of diagnosis, and 1 year after treatment. Group 2 had 11 patients in the late postacute phase who were evaluated 5.2 years on average after diagnosis and treatment. The researchers also performed ECGs with the Selvester score, 24‐hour Holter exam, and cardiovascular magnetic resonance imaging.
The study led to the following findings:
- The mean age of the 23 patients was 44.3±18.9 years, and they were mostly men (15/65.24%) from Amazonas state (22/95.6%).
- In 69.6% (n=16) of the patients, some ECG alterations were found, the most frequent being left anterior fascicular block and ventricular repolarization.
- In Group 1, the 24‐hour Holter exam showed atrial tachycardia in 25% of patients and ventricular extrasystoles in 16.7% of patients.
- In Group 2, 1 patient had ventricular extrasystoles.
- Myocardial injury was observed in 58.3% at the acute phase and in 50% of patients at the 1‐year follow‐up in Group 1 and in 18.2% of patients in Group 2.
The researchers conclude, "Acute Chagas disease can cause myocardial injury that can be detected by cardiovascular magnetic resonance with potential prognostic and diagnostic value."
Reference:
Couceiro KDN, Ortiz JV, Hosannah da Silva E Silva MR, Teixeira de Sousa DR, Andrade RC Jr, Brandão ARJ, de Morais RF, Smith Doria S, Fonseca RA, da Silva PRL, Fernandes F, Guerra MDGVB, Rochitte CE, Ferreira JMBB, Guerra JAO. Myocardial Injury in Patients With Acute and Subacute Chagas Disease in the Brazilian Amazon Using Cardiovascular Magnetic Resonance. J Am Heart Assoc. 2022 Jun 22:e021806. doi: 10.1161/JAHA.121.021806. Epub ahead of print. PMID: 35730620.
