PMID- 26581396 OWN - NLM STAT- MEDLINE DCOM- 20160707 LR - 20240117 IS - 1532-429X (Electronic) IS - 1097-6647 (Print) IS - 1097-6647 (Linking) VI - 17 DP - 2015 Nov 18 TI - Myocardial tissue characterization in Chagas' heart disease by cardiovascular magnetic resonance. PG - 97 LID - 10.1186/s12968-015-0200-7 [doi] LID - 97 AB - BACKGROUND: Chagas' heart disease is an important public health problem in South America. Several aspects of the pathogenesis are not fully understood, especially in its subclinical phases. On pathology Chagas' heart disease is characterized by chronic myocardial inflammation and extensive myocardial fibrosis. The latter has also been demonstrated by late gadolinium enhancement (LGE) by cardiovascular magnetic resonance (CMR). In three clinical phases of this disease, we sought to investigate the presence of LGE, myocardial increase in signal intensity in T2-weighted images (T2W) and in T1-weighted myocardial early gadolinium enhancement (MEGE), previously described CMR surrogates for myocardial fibrosis, myocardial edema and hyperemia, respectively. METHODS: Fifty-four patients were analyzed. Sixteen patients with the indeterminate phase (IND), seventeen patients with the cardiac phase with no left ventricular systolic dysfunction (CPND), and twenty-one patients with the cardiac phase with left ventricular systolic dysfunction (CPD). All patients underwent 1.5 T CMR scan including LGE, T2W and MEGE image sequences to evaluate myocardial abnormalities. RESULTS: Late gadolinium enhancement was present in 72.2 % of all patients, in 12.5 % of IND, 94.1 % of the CPND and 100 % of the CPD patients (p < 0.0001). Myocardial increase in signal intensity in T2-weighted images (T2W) was present in 77.8 % of all patients, in 31.3 % of the IND, 94.1 % of the CPND and 100 % of the CPD patients (p < 0.0001). T1-weighted myocardial early gadolinium enhancement (MEGE) was present in 73.8 % of all patients, in 25.0 % of the IND, 92.3 % of the CPND and 94.1 % of the CPD (p < 0.0001). A good correlation between LGE and T2W was observed (r = 0.72, and p < 0.001). CONCLUSIONS: Increase in T2-weighted (T2W) myocardial signal intensity and T1-weighted myocardial early gadolinium enhancement (MEGE) can be detected by CMR in patients throughout all phases of Chagas' heart disease, including its subclinical presentation (IND). Moreover, those findings were parallel to myocardial fibrosis (LGE) in extent and location and also correlated with the degree of Chagas' heart disease clinical severity. These findings contribute to further the knowledge on pathophysiology of Chagas' heart disease, and might have therapeutic and prognostic usefulness in the future. FAU - Torreao, Jorge A AU - Torreao JA AD - Heart Institute, InCor, University of Sao Paulo Medical School,Cardiovascular Magnetic Resonance andComputed Tomography Sector, Av. Dr. Eneas de Carvalho Aguiar, 44, Andar AB, Cerqueira Cesar, Sao Paulo, SP, 05403-000, Brazil. jatorreao@hotmail.com. AD - Santa Izabel Hospital, Santa Casa de Misericordia da Bahia, Bahia, Brazil. jatorreao@hotmail.com. FAU - Ianni, Barbara M AU - Ianni BM AD - Heart Institute, InCor, University of Sao Paulo Medical School,Cardiovascular Magnetic Resonance andComputed Tomography Sector, Av. Dr. Eneas de Carvalho Aguiar, 44, Andar AB, Cerqueira Cesar, Sao Paulo, SP, 05403-000, Brazil. barbara.ianni@incor.usp.br. FAU - Mady, Charles AU - Mady C AD - Heart Institute, InCor, University of Sao Paulo Medical School,Cardiovascular Magnetic Resonance andComputed Tomography Sector, Av. Dr. Eneas de Carvalho Aguiar, 44, Andar AB, Cerqueira Cesar, Sao Paulo, SP, 05403-000, Brazil. charles.mady@incor.usp.br. FAU - Naia, Evandro AU - Naia E AD - Heart Institute, InCor, University of Sao Paulo Medical School,Cardiovascular Magnetic Resonance andComputed Tomography Sector, Av. Dr. Eneas de Carvalho Aguiar, 44, Andar AB, Cerqueira Cesar, Sao Paulo, SP, 05403-000, Brazil. evandronaia@gmail.com. FAU - Rassi, Carlos H AU - Rassi CH AD - Heart Institute, InCor, University of Sao Paulo Medical School,Cardiovascular Magnetic Resonance andComputed Tomography Sector, Av. Dr. Eneas de Carvalho Aguiar, 44, Andar AB, Cerqueira Cesar, Sao Paulo, SP, 05403-000, Brazil. carloshrer@uol.com.br. FAU - Nomura, Cesar AU - Nomura C AD - Heart Institute, InCor, University of Sao Paulo Medical School,Cardiovascular Magnetic Resonance andComputed Tomography Sector, Av. Dr. Eneas de Carvalho Aguiar, 44, Andar AB, Cerqueira Cesar, Sao Paulo, SP, 05403-000, Brazil. cesarnomura@gmail.com. FAU - Parga, Jose R AU - Parga JR AD - Heart Institute, InCor, University of Sao Paulo Medical School,Cardiovascular Magnetic Resonance andComputed Tomography Sector, Av. Dr. Eneas de Carvalho Aguiar, 44, Andar AB, Cerqueira Cesar, Sao Paulo, SP, 05403-000, Brazil. parga@incor.usp.br. FAU - Avila, Luis F AU - Avila LF AD - Heart Institute, InCor, University of Sao Paulo Medical School,Cardiovascular Magnetic Resonance andComputed Tomography Sector, Av. Dr. Eneas de Carvalho Aguiar, 44, Andar AB, Cerqueira Cesar, Sao Paulo, SP, 05403-000, Brazil. avila@incor.usp.br. FAU - Ramires, Jose A F AU - Ramires JA AD - Heart Institute, InCor, University of Sao Paulo Medical School,Cardiovascular Magnetic Resonance andComputed Tomography Sector, Av. Dr. Eneas de Carvalho Aguiar, 44, Andar AB, Cerqueira Cesar, Sao Paulo, SP, 05403-000, Brazil. jose.ramires@incor.usp.br. FAU - Kalil-Filho, Roberto AU - Kalil-Filho R AD - Heart Institute, InCor, University of Sao Paulo Medical School,Cardiovascular Magnetic Resonance andComputed Tomography Sector, Av. Dr. Eneas de Carvalho Aguiar, 44, Andar AB, Cerqueira Cesar, Sao Paulo, SP, 05403-000, Brazil. roberto.kalil@incor.usp.br. FAU - Rochitte, Carlos E AU - Rochitte CE AD - Heart Institute, InCor, University of Sao Paulo Medical School,Cardiovascular Magnetic Resonance andComputed Tomography Sector, Av. Dr. Eneas de Carvalho Aguiar, 44, Andar AB, Cerqueira Cesar, Sao Paulo, SP, 05403-000, Brazil. rochitte@incor.usp.br. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20151118 PL - England TA - J Cardiovasc Magn Reson JT - Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance JID - 9815616 RN - 0 (Contrast Media) RN - 0 (Heterocyclic Compounds) RN - 0 (Organometallic Compounds) RN - 99J2XUF1JT (gadolinium 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetate) SB - IM MH - Adult MH - Aged MH - Chagas Cardiomyopathy/parasitology/*pathology/physiopathology MH - Contrast Media MH - Cross-Sectional Studies MH - Edema, Cardiac/parasitology/*pathology/physiopathology MH - Female MH - Fibrosis MH - Heterocyclic Compounds MH - Humans MH - *Magnetic Resonance Imaging MH - Male MH - Middle Aged MH - Myocardium/*pathology MH - Organometallic Compounds MH - Predictive Value of Tests MH - Severity of Illness Index MH - Systole MH - Ventricular Dysfunction, Left/parasitology/*pathology/physiopathology MH - Ventricular Function, Left PMC - PMC4652401 EDAT- 2015/11/20 06:00 MHDA- 2016/07/09 06:00 PMCR- 2015/11/18 CRDT- 2015/11/20 06:00 PHST- 2015/07/10 00:00 [received] PHST- 2015/10/30 00:00 [accepted] PHST- 2015/11/20 06:00 [entrez] PHST- 2015/11/20 06:00 [pubmed] PHST- 2016/07/09 06:00 [medline] PHST- 2015/11/18 00:00 [pmc-release] AID - S1097-6647(23)00922-5 [pii] AID - 200 [pii] AID - 10.1186/s12968-015-0200-7 [doi] PST - epublish SO - J Cardiovasc Magn Reson. 2015 Nov 18;17:97. doi: 10.1186/s12968-015-0200-7.