Abstract 2843: Evaluation of Early Myocardium Damage in Patients with Chagas’ Disease with Diastolic Function Analysis and Doppler Tissue Imaging
Chagas’ disease represents one of the main causes of mortality in Latin America and is becoming a relevant public health problem in EEUU and Europe because of the migratory movements. About one third of Chagas infected people develop a severe and potentially lethal cardiac dysfunction. Early identification of myocardium damage in asymptomatic patients (undetermined phase) would be very important for risk stratification and treatment. Our aim was to establish the usefulness of diastolic function measurement and the implementation of Doppler tissue imaging (DTI) techniques to identify patients with early myocardium damage. Thirty-one patients were studied; including 21 recent diagnosed asymptomatic chagasic patients and 10 non infected control individuals. All patients were assessed with a conventional 2D-echocardiography with diastolic function analysis and images acquisition for applying DTI. Comparisons of continuous variables between two groups were performed by T-test analysis or the Mann-Whitney U test according to normality. Conventional 2D-echocardiogram showed normality of left ventricular (LV) dimensions and LV ejection fraction for all 31 patients, without differences between both groups. However, chagasic patients presented a statistically significant lengthening of the deceleration time of early diastolic filling (DT), a higher left atrium volume (LAV) and a reduced early diastolic mitral annular velocity (Em) comparing to controls individuals. When evaluating the systolic velocity of longitudinal contractility, DTI showed a trend to lower systolic velocity at inferior and anterior walls (table⇓). In patients with Chagas’ disease who are in the undetermined phase, LA volumes and diastolic dysfunction allowed to identify early cardiac abnormalities. Doppler tissue imaging might also be a potentially useful tool for detecting incipient myocardial alteration in this context.