Nuclear Medicine Methods for Assessment of Chronic Chagas Heart Disease

Author(s)

Marcus Vinicius Simões ^[1] ; Denise Mayumi Tanaka ^[2] ; José Antonio Marin-Neto ^[3]

Affiliation

^[1] Universidade de São Paulo - Brasil

^[2] Universidade de São Paulo - Brasil

^[3] Universidade de São Paulo - Brasil

• Document type: Journal article
• Source: International Journal of Cardiovascular Sciences; v. 33, n. 6, p. 686-696, 2020-11-25.

Abstract

Abstract Several different imaging methods can be used to evaluate patients with Chagas heart disease (CHD) for diagnostic and prognostic purposes, including plain chest radiography; echocardiography; myocardial perfusion scintigraphy, for detection of ischemia and fibrosis; radionuclide gated-angiography, for evaluation of biventricular function; 123I-MIBG labeling of sympathetic myocardial innervation; MRI, for detection and quantitation of myocardial fibrosis; and coronary angiography. This study aims to review the contributions of these nuclear medicine methods to understanding of the pathophysiology of chronic Chagas cardiomyopathy (CCC). Careful analysis and integration of findings provided by these imaging methods in patients with CCC at different stages has contributed significantly to improving understanding of several peculiarities of the disease. Clinical and experimental studies in animal models show that perfusion abnormalities detected in association with dysfunctional but viable myocardium are a common finding in CCC patients and correspond to areas of cardiac sympathetic denervation, as assessed by 123I-MIBG imaging. Furthermore, recent reports have demonstrated a close relationship between coronary microvascular disturbances and myocardial inflammation. Thus, ongoing research, mainly focused on refinements of 18F-FDF -PET techniques and further exploration of nuclear methods, such as SPECT, have the potential to contribute to detection and monitoring of early subclinical myocardial damage thereby enabling evaluation of therapeutic strategies targeting inflammation and microvascular ischemia that could result in better prognostic stratification of patients with CHD. (AU)

• FAPESP's process: 17/16450-6 - EFFECTS OF PROLONGED USE OF PENTOXIFILINE OVER MYOCARDIAL PERFUSION CHANGES, ARRYTHMIA EVENTS AND LEFT VENTRICULAR DYSFUNCTION IN THE CHRONIC CHAGAS CARDIOMYOPATHY
• Grantee: Marcus Vinicius Simões
• Support Opportunities: Regular Research Grants
• FAPESP's process: 16/25403-9 - Investigations on the pathogenesis, pathophysiology and therapy in humans and in an experimental model with the chronic cardiomyopathy of Chagas Disease
• Grantee: José Antonio Marin-Neto
• Support Opportunities: Research Projects - Thematic Grants