PMID- 16003275
OWN - NLM
STAT- MEDLINE
DCOM- 20060411
LR  - 20220311
IS  - 1097-6795 (Electronic)
IS  - 0894-7317 (Linking)
VI  - 18
IP  - 7
DP  - 2005 Jul
TI  - Peculiar aspects of cardiogenic embolism in patients with Chagas' cardiomyopathy: 
      a transthoracic and transesophageal echocardiographic study.
PG  - 761-7
AB  - OBJECTIVES: We sought to detect cardiac thrombi by transthoracic and 
      transesophageal echocardiography in patients with Chagas' cardiomyopathy and to 
      determine the relationship of these thrombi with left ventricular systolic 
      function and with the presence of stroke. BACKGROUND: Thromboembolic events are a 
      serious complication of Chagas' cardiomyopathy. Because most data come from 
      autopsy studies, the prevalence of cardiac thrombi for patients who are 
      clinically stable is unknown. METHODS: A total of 75 patients (52 men; mean age 
      48 +/- 13 years) with Chagas' cardiomyopathy were prospectively studied by 
      transthoracic and transesophageal echocardiography and followed for 24 +/- 10 
      months. RESULTS: In all, 14 patients (19%) had a history of stroke at the time of 
      enrollment and two had this complication at follow-up. Most patients (88%) were 
      in New York Heart Association (NYHA) functional classes I and II and 9 (12%) were 
      in classes III and IV. Mean ejection fraction was 40 +/- 13%. A total of 17 
      patients (23%) had left ventricular thrombus on transthoracic echocardiography 
      and this finding was associated with a history of stroke ( P = .01). Apical 
      aneurysm occurred in 35 patients (47%) and it was associated both with thrombus 
      and stroke ( P = .04). Strokes were more frequent ( P = .04) among patients with 
      mild systolic dysfunction (57% of patients with strokes were in NYHA I). Four 
      patients (5%) had thrombi at the left atrial appendage, and one (1%) at the right 
      atrial appendage. A total of 13 patients (17%) died at follow-up. CONCLUSIONS: 
      Stroke was frequent in Chagas' cardiomyopathy and associated with mild systolic 
      dysfunction and with intracardiac thrombi. These occurred mainly in the typical 
      apical aneurysm of Chagas' disease.
FAU - Nunes, Maria do Carmo P
AU  - Nunes Mdo C
AD  - Postgraduate Course of Tropical Medicine, Federal University of Minas Gerais, 
      Belo Horizonte, Brazil. mcarmo@waymail.com.br
FAU - Barbosa, Marcia M
AU  - Barbosa MM
FAU - Rocha, Manoel Otavio C
AU  - Rocha MO
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Am Soc Echocardiogr
JT  - Journal of the American Society of Echocardiography : official publication of the 
      American Society of Echocardiography
JID - 8801388
SB  - IM
MH  - Brazil/epidemiology
MH  - Chagas Cardiomyopathy/*diagnostic imaging/*epidemiology
MH  - Comorbidity
MH  - Echocardiography/statistics & numerical data
MH  - Echocardiography, Transesophageal/statistics & numerical data
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Intracranial Embolism/diagnostic imaging/*epidemiology
MH  - Male
MH  - Middle Aged
MH  - Risk Assessment/methods
MH  - Risk Factors
MH  - Stroke/diagnosis/*epidemiology
MH  - Thrombosis/diagnosis/*epidemiology
MH  - Ventricular Dysfunction, Left/diagnosis/*epidemiology
EDAT- 2005/07/09 09:00
MHDA- 2006/04/12 09:00
CRDT- 2005/07/09 09:00
PHST- 2005/07/09 09:00 [pubmed]
PHST- 2006/04/12 09:00 [medline]
PHST- 2005/07/09 09:00 [entrez]
AID - S0894731705000763 [pii]
AID - 10.1016/j.echo.2005.01.026 [doi]
PST - ppublish
SO  - J Am Soc Echocardiogr. 2005 Jul;18(7):761-7. doi: 10.1016/j.echo.2005.01.026.