Title
Early identification of patients with Chagas disease at risk of developing cardiomyopathy using 2-D speckle tracking strain: Win, Miranda prediction of Chagas cardiomyopathy
Date Issued
01 August 2022
Access level
open access
Resource Type
journal article
Author(s)
Win S.
Miranda-Schaeubinger M.
Gustavo Durán Saucedo R.
Carballo Jimenez P.
Flores J.
Mercado-Saavedra B.
Camila Telleria L.
Raafs A.
Bern C.
Tinajeros F.
Heymans S.
Marcus R.
Mukherjee M.
Universidad Peruana Cayetano Heredia
Johns Hopkins University
Publisher(s)
Elsevier Ireland Ltd
Abstract
Background: Chagas disease is an endemic protozoan disease with high prevalence in Latin America. Of those infected, 20–30% will develop chronic Chagas cardiomyopathy (CCC) however, prediction using existing clinical criteria remains poor. In this study, we investigated the utility of left ventricular (LV) echocardiographic speckle-tracking global longitudinal strain (GLS) for early detection of CCC. Methods and results: 139 asymptomatic T. cruzi seropositive subjects with normal heart size and normal LV ejection fraction (EF) (stage A or B) were enrolled in this prospective observational study and underwent paired echocardiograms at baseline and 1-year follow-up. Progressors were participants classified as stage C or D at follow-up due to development of symptoms of heart failure, cardiomegaly, or decrease in LVEF. LV GLS was calculated as the average peak systolic strain of 16 LV segments. Measurements were compared between participants who progressed and did not progress by two-sample t-test, and the odds of progression assessed by multivariable logistic regression. Of the 139 participants, 69.8% were female, mean age 55.8 ± 12.5 years, with 12 (8.6%) progressing to Stage C or D at follow-up. Progressors tended to be older, male, with wider QRS duration. LV GLS was −19.0% in progressors vs. –22.4% in non-progressors at baseline, with 71% higher odds of progression per +1% of GLS (adjusted OR 1.71, 95% CI 1.20–2.44, p = 0.003). Conclusion: Baseline LV GLS in participants with CCC stage A or B was predictive of progression within 1-year and may guide timing of clinical follow-up and promote early detection or treatment.
Volume
41
Language
English
OCDE Knowledge area
Parasitología Sistema cardiaco, Sistema cardiovascular
Scopus EID
2-s2.0-85130604768
Source
IJC Heart and Vasculature
ISSN of the container
23529067
Sponsor(s)
Financial support was provided by the National Institute of Allergy and Infectious Diseases, National Institutes of Health - 1R01AI107028-01A1. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The Chagas Working Group includes:, Sassan Noazin and Fatemeh Jahan Bakhsh from Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. Jessy Condori, Margot Ramirez Jaldin, Eliana Carolina Saenza Vasquez, Steffany Vucetich and. Lorena Guibarra all affiliated with Asociación Benéfica Prisma. Santa Cruz, Bolivia. Robert H. Gilman, Caryn Bern, Freddy Tinajeros, Monica Mukherjee, Jorge Flores, and Manuela Verastegui were involved in planning of the study. Paula Carballo Jimenez, Ronald Gustavo Durán Saucedo, Lola Camila Telleria, Brandon Mercado Saavedra, Monica Miranda-Schaeubinger, and Sithu Win were involved in conduct of the research, Monica Miranda-Schaeubinger, Sithu Win, Paula Carballo Jimenez, Ronald Gustavo Durán Saucedo, Anne Raafs, Stephane Heymans, Rachel Marcus, Robert H. Gilman, and Monica Mukherjee were involved in reporting of work. Robert H. Gilman is responsible for the overall content as guarantor. Echocardiography, cardiomyopathy, heart failure. Financial support was provided by the National Institute of Allergy and Infectious Diseases, National Institutes of Health - 1R01AI107028-01A1. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Sources of information: Directorio de Producción Científica Scopus