Biventricular dysfunction in Chagas' disease, evaluated by myocardial deformity echocardiographic techniques, and its correlation with cardiac magnetic resonance.

• Grant number: 15/24319-1
• Support Opportunities: Scholarships abroad - Research
• Start date: August 01, 2016
• End date: July 18, 2017
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Minna Moreira Dias Romano
• Grantee: Minna Moreira Dias Romano
• Host Investigator: Eric J. Velazquez
• Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil
• Institution abroad: Duke University, United States

Abstract

Chagas' disease is still a significant public health issue in South America, and Chronic Chagas' cardiomyopathy (CCC) is the most ominous form of this disease. Myocardial damage can be detected even in the indeterminate form of the disease, but there are several aspects not well understood in this condition, including the ventricular damage progression. Investigating myocardial strain alterations with Speckle Tracking (ST) Echocardiography has a good perspective on the identification of early myocardial damage, especially in patients in the indeterminate form of the disease. Right ventricular involvement is another challenge, and can happen, in a few cases, even before any detectable dysfunction of the left ventricle. The circumferential myocardial strain can be a tool to understand this ventricular interdependence. Cardiac Magnetic Resonance (CMR) is a gold standard to quantify myocardial fibrosis as well as a technique capable of evaluating myocardial strain. The aim of this project is to characterize left and right myocardial strain in chagasic patients and its correlation with myocardial fibrosis. Methods: Chagasic volunteers both in the non-cardiac and cardiac forms of the disease will be investigated with echocardiography and CMR examinations. Conventional echocardiography measurements of chambers size and ejection fraction (EF) will be acquired, besides longitudinal, radial and circumferential strain measures from both ventricles. CMR will measure EF of both ventricles, besides fibrosis quantification with gadolinium and myocardial strain with the "tagging" technique. Comparisons between Control, Chronic Chagasic Cardiac (CCC) and Non Cardiac Form (Indeterminate and Digestive Forms) groups will use appropriate statistic methods and correlation tests between echo and CMR will be applied.