Relationship between microvascular changes, autonomic denervation, and myocardial fibrosis in Chagas cardiomyopathy: Evaluation by MRI and SPECT imaging

Autor(es)

Barizon, Gustavo Canavaci ^[1] ; Simoes, Marcus Vinicius ^[2] ; Schmidt, Andre ^[2] ; Gadioli, Leonardo Pippa ^[2] ; Murta Junior, Luiz Otavio ^[1]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Dept Comp & Math, Ave Bandeirantes 3900, BR-14040901 Ribeirao Preto, SP - Brazil

^[2] Univ Sao Paulo, Med Sch Ribeirao Preto, Div Cardiol, Ribeirao Preto - Brazil

• Tipo de documento: Artigo Científico
• Fonte: JOURNAL OF NUCLEAR CARDIOLOGY; v. 27, n. 2, p. 434-444, APR 2020.
• Citações Web of Science: 1

Resumo

Background The relationship between microvasculopathy, autonomic denervation, and myocardial fibrosis, in Chagas cardiomyopathy is incompletely understood. The aim of this study was to explore the relative extent and anatomic distribution of myocardial hypoperfusion, autonomic denervation, and myocardial scarring using Single-Photon Emission Computerized Tomography (SPECT) imaging and Magnetic Resonance Imaging (MRI). Methods Thirteen patients with Chagas disease all had Iodine-123-metaiodobenzylguanidine (MIBG) SPECT, Tc-99m-Sestamibi (MIBI) rest-stress SPECT, and gadolinium late enhancement MRI imaging within a 2-month interval. The anatomic location and extent of denervation, of stress-induced hypoperfusion and fibrosis, were assessed through image co-registration and quantification of abnormal tissue areas as a percent of total myocardium. Results The results showed a strong general anatomic concordance between areas of hypoperfusion, denervation, and fibrosis, suggesting that the three abnormal features may be correlated. Myocardial denervation was anatomically and quantitatively closely associated areas of stress hypoperfusion. Conclusion Combined myocardial analysis of the extent and location of autonomic denervation, hypoperfusion, and scarring may allow for better understanding of the pathophysiology of Chagas cardiomyopathy. Autonomic myocardial denervation may be a more sensitive marker of cardiac involvement in Chagas Disease than finding by other imaging modalities. (AU)

• Processo FAPESP: 08/04140-3 - Estudo da correlação entre a extensão da denervação simpática miocárdica e eventos arrítmicos em portadores de miocardiopatia chagásica crônica
• Beneficiário: Marcus Vinicius Simões
• Modalidade de apoio: Auxílio à Pesquisa - Regular