PMID- 35783835 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240125 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 9 DP - 2022 TI - Diffuse Myocardial Fibrosis and Cardiomyocyte Diameter Are Associated With Heart Failure Symptoms in Chagas Cardiomyopathy. PG - 880151 LID - 10.3389/fcvm.2022.880151 [doi] LID - 880151 AB - BACKGROUND: Chronic Chagas cardiomyopathy (CCC) constitutes the most life-threatening consequence of the Trypanosoma cruzi infection. Our goal was to test in CCC the associations of the myocardial tissue phenotype with cardiac dysfunction, and heart failure (HF) severity, using cardiac magnetic resonance (CMR). METHODS: We performed a prospective observational cohort of patients with consecutive CCC with a CMR protocol, including ventricular function, myocardial T1, and late gadolinium enhancement (LGE). Extracellular volume (ECV), and intracellular water lifetime, tau(ic), a measure of cardiomyocyte diameter, were compared to CCC disease progression, including Rassi score and New York Heart Association (NYHA) class. An exploratory prognostic analysis was performed to investigate the association of both ECV and tau(ic) with CV death. RESULTS: A total of 37 patients with intermediate-to-high-risk CCC were enrolled (Chagas Rassi score >/=7, mean left ventricle (LV) ejection fraction (EF) 32 +/- 16%). Myocardial ECV (0.40 +/- 0.07) was correlated with Rassi score (r = 0.43; P = 0.009), higher NYHA class, and LV EF (r = -0.51; P = 0.0015). tau(ic) decreased linearly with NYHA class (P = 0.007 for non-parametric test of linear trend) and showed a positive association with LV EF (r = 0.47; P = 0.004). Over a median follow-up of 734 days (range: 6-2,943 days), CV death or cardiac transplantation occurred in 10 patients. The Rassi score (heart rate [HR] = 1.3; 95% CI = [1.0, 1.8]; P = 0.028) and ECV (HR = 3.4 for 0.1 change, 95% CI = [1.1, 11.0], P = 0.039) were simultaneously associated with CV death. CONCLUSION: In patients with intermediate-to-high-risk CCC, an expanded ECV and regression of cardiomyocyte diameter were associated with worsening systolic function and HF severity, respectively. The exploratory analysis indicates that ECV may have a prognostic value to identify patients with CCC at a higher risk for cardiovascular events. CI - Copyright (c) 2022 Nardi Gemme, Silva, Martins, da Silva, Paim, Sposito, Nadruz, Fernandes, San Juan Dertkigil, da Silva Wanderley, de Almeida, Metze, Neilan, Jerosch-Herold and Coelho-Filho. FAU - Nardi Gemme, Cristiane AU - Nardi Gemme C AD - Faculdade de Ciencias Medicas, Universidade Estadual de Campinas, Sao Paulo, Brazil. FAU - Silva, Thiago Quinaglia A C AU - Silva TQAC AD - Faculdade de Ciencias Medicas, Universidade Estadual de Campinas, Sao Paulo, Brazil. AD - Division of Cardiology, Department of Radiology, Cardiovascular Imaging Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States. FAU - Martins, Luiz C AU - Martins LC AD - Faculdade de Ciencias Medicas, Universidade Estadual de Campinas, Sao Paulo, Brazil. FAU - da Silva, Luis Miguel AU - da Silva LM AD - Faculdade de Ciencias Medicas, Universidade Estadual de Campinas, Sao Paulo, Brazil. FAU - Paim, Layde Rosane AU - Paim LR AD - Faculdade de Ciencias Medicas, Universidade Estadual de Campinas, Sao Paulo, Brazil. FAU - Sposito, Andrei AU - Sposito A AD - Faculdade de Ciencias Medicas, Universidade Estadual de Campinas, Sao Paulo, Brazil. FAU - Nadruz, Wilson AU - Nadruz W AD - Faculdade de Ciencias Medicas, Universidade Estadual de Campinas, Sao Paulo, Brazil. FAU - Fernandes, Fabio AU - Fernandes F AD - Cardiomyopathy Unit, Heart Institute, University of Sao Paulo, Sao Paulo, Brazil. FAU - San Juan Dertkigil, Sergio AU - San Juan Dertkigil S AD - Faculdade de Ciencias Medicas, Universidade Estadual de Campinas, Sao Paulo, Brazil. FAU - da Silva Wanderley, Jamiro AU - da Silva Wanderley J AD - Faculdade de Ciencias Medicas, Universidade Estadual de Campinas, Sao Paulo, Brazil. FAU - de Almeida, Eros A AU - de Almeida EA AD - Faculdade de Ciencias Medicas, Universidade Estadual de Campinas, Sao Paulo, Brazil. FAU - Metze, Konradin AU - Metze K AD - Faculdade de Ciencias Medicas, Universidade Estadual de Campinas, Sao Paulo, Brazil. FAU - Neilan, Tomas G AU - Neilan TG AD - Division of Cardiology, Department of Radiology, Cardiovascular Imaging Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States. FAU - Jerosch-Herold, Michael AU - Jerosch-Herold M AD - Non-invasive Cardiovascular Imaging Program, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States. FAU - Coelho-Filho, Otavio R AU - Coelho-Filho OR AD - Faculdade de Ciencias Medicas, Universidade Estadual de Campinas, Sao Paulo, Brazil. LA - eng GR - K24 HL150238/HL/NHLBI NIH HHS/United States PT - Journal Article DEP - 20220617 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC9247201 OTO - NOTNLM OT - Chagas disease OT - cardiac magnetic resonance OT - cardiomyocyte diameter OT - heart failure OT - interstitial fibrosis COIS- TN has received support from Astra Zeneca, Bristol Myer Squibb, AbbVie, Amgen, and H3 Biomedicine. ORCF has received research grants and/or speaking honoraria from Amgen, Astra Zeneca, Bayer, Boehringer Ingelheim, Novartis, Takeda, and Pfizer. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2022/07/06 06:00 MHDA- 2022/07/06 06:01 PMCR- 2022/01/01 CRDT- 2022/07/05 10:16 PHST- 2022/02/21 00:00 [received] PHST- 2022/04/26 00:00 [accepted] PHST- 2022/07/05 10:16 [entrez] PHST- 2022/07/06 06:00 [pubmed] PHST- 2022/07/06 06:01 [medline] PHST- 2022/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2022.880151 [doi] PST - epublish SO - Front Cardiovasc Med. 2022 Jun 17;9:880151. doi: 10.3389/fcvm.2022.880151. eCollection 2022.