Left Atrial Dysfunction in Chagas Cardiomyopathy Is More Severe Than in Idiopathic Dilated Cardiomyopathy: A Study with Real-Time Three-Dimensional Echocardiography

Left Atrial Dysfunction in Chagas Cardiomyopathy Is More Severe Than in Idiopathic Dilated Cardiomyopathy: A Study with Real-Time Three-Dimensional Echocardiography

Author Mancuso, Frederico J. N. Autor UNIFESP Google Scholar
Almeida, Dirceu R. Autor UNIFESP Google Scholar
Moises, Valdir A. Autor UNIFESP Google Scholar
Oliveira, Wercules A. Autor UNIFESP Google Scholar
Mello, Eduardo S. Autor UNIFESP Google Scholar
Poyares, Dalva Autor UNIFESP Google Scholar
Tufik, Sergio Autor UNIFESP Google Scholar
Carvalho, Antonio C. C. Autor UNIFESP Google Scholar
Campos, Orlando Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Background: Although there is anatomopathologic evidence of atrial involvement in Chagas cardiomyopathy (CCM), the impact in left atrial (LA) function is unknown. the aim of this study was to evaluate LA function in patients with CCM with real-time three-dimensional echocardiography (RT3DE) and to compare it with patients with idiopathic dilated cardiomyopathy (DCM).Methods: A total of 30 patients with CCM, 30 patients with DCM, and 20 normal subjects used as the control group were studied. With the use of RT3DE, we measured LA maximum (maxLAV), minimum, and pre-atrial contraction volumes and calculated total and active LA emptying fractions.Results: Left ventricular ejection fraction and mitral regurgitation were similar in both groups. MaxLAV/m(2) was larger in the CCM group than in the DCM group (76.9 +/- 21.9 mL vs. 59.1 +/- 26.0 mL; P < .01), and both were significantly larger than in the control group (P < .01). Total LA emptying fraction was lower in the CCM group than in the DCM group (0.30 +/- 0.10 vs. 0.40 +/- 0.12; P < .01), and both were lower than in the control group (P = .01). Active LA emptying fraction was also lower in the CCM group than in the DCM group (0.22 +/- 0.09 vs. 0.28 +/- 0.11; P < .01), and both were lower than in the control group (P = .01). the E/e' ratio was higher in the CCM group than in the DCM group (21 +/- 10 vs. 15 +/- 6; P < .01), and both were greater than in the control group (P < .01). in a multiple regression model, the E/e' ratio was the only independent predictor of a worsening active LA emptying fraction.Conclusion: LA function is more compromised in patients with CCM than in patients with DCM. This finding indicates a more diffuse and severe myocardial impairment in Chagas disease that is probably related to increased left ventricular filling pressures and atrial myopathy. (J Am Soc Echocardiogr 2011;24:526-32.)
Keywords Cardiomyopathy
Chagas disease
Left atrium
Real-time three-dimensional echocardiography
Language English
Date 2011-05-01
Published in Journal of the American Society of Echocardiography. New York: Mosby-Elsevier, v. 24, n. 5, p. 526-532, 2011.
ISSN 0894-7317 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 526-532
Origin http://dx.doi.org/10.1016/j.echo.2011.01.013
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000289779500008
URI http://repositorio.unifesp.br/handle/11600/33647

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