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Left ventricular longitudinal strain and strain rate measurements in paediatric patients in long-term treatment for Chagas disease

Published online by Cambridge University Press:  02 March 2021

Alejandro Goldsman*
Affiliation:
Cardiology service Ricardo Gutiérrez Children’s Hospital, Buenos Aires, Argentina
Haydee Vazquez
Affiliation:
Cardiology service Ricardo Gutiérrez Children’s Hospital, Buenos Aires, Argentina
Alberto Quilindro
Affiliation:
Cardiology service Ricardo Gutiérrez Children’s Hospital, Buenos Aires, Argentina
María Sicurello
Affiliation:
Cardiology service Ricardo Gutiérrez Children’s Hospital, Buenos Aires, Argentina
Mariana Cazalas
Affiliation:
Cardiology service Ricardo Gutiérrez Children’s Hospital, Buenos Aires, Argentina
Jaime Altcheh
Affiliation:
Parasitology service Ricardo Gutiérrez Children’s Hospital, Buenos Aires, Argentina
Nicolás González
Affiliation:
Parasitology service Ricardo Gutiérrez Children’s Hospital, Buenos Aires, Argentina
Claudio Moros
Affiliation:
Cardiology service Ricardo Gutiérrez Children’s Hospital, Buenos Aires, Argentina
María Grippo
Affiliation:
Cardiology service Ricardo Gutiérrez Children’s Hospital, Buenos Aires, Argentina
*
Author for correspondence: Dr A. Goldsman, Cardiology service Ricardo Gutiérrez Children’s Hospital, Av. Angel Gallardo 36 8°18, 1405Buenos Aires, Argentina. Tel: +541144179085; Fax: +541148620457. E-mail: agoldsman@hotmail.com

Abstract

Introduction:

Previous echocardiographic studies failed to show residual alterations of heart function in paediatric patients that have received treatment for Chagas disease. While the echocardiogram is the fundamental front-line tool for evaluating heart function, the appearance of new techniques allows a more detailed analysis. We aimed to evaluate systolic and diastolic function with new techniques in a paediatric population with Chagas disease several years after treatment completion.

Material and methods:

Echocardiograms were obtained from 84 Chagas disease patients (48 female) and 27 healthy controls. All patients had received treatment concluding on average 10 years prior to the study. The prospective analysis considered cardiac dimensions and cardiac function using two-dimensional, M-mode, Doppler and tissue Doppler imaging with emphasis on measuring longitudinal strain in the left ventricle by speckle tracking. Ejection fraction was measured with three-dimensional echocardiography.

Results:

Patients had an age of 14.2 ± 5.7 years (6–33) at the time of evaluation. Global and segmental motility of the left ventricle was normal in all patients. Ejection fraction was 59.2 ± 6.5 and 57.4 ± 6.5% (p = 0.31) in patients and controls respectively. Left ventricular global longitudinal systolic strain was −19 ± 2.4% in patients and −19 ± 3.6% (p = 0.91) in controls. No significant differences were found in remaining systolic and diastolic function measurements.

Conclusions:

Paediatric patients that have received treatment for Chagas disease, evaluated with either conventional techniques or new tools, do not show significant long-term alterations of ventricular function.

Type
Original Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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References

Organización Mundial de la Salud. Retrieved from http://www.who.int/mediacentre/factsheets/fs340/es/ Google Scholar
Organización Panamericana de Salud. Retrieved from http://www.paho.org/es/temas/enfermedad-chagas Google Scholar
Moscatelli, G, García Bournissen, F, Freilij, H, et al. Impact of migration on the occurrence of new cases of Chagas disease in Buenos Aires City, Argentina. J Infect Dev Count 2013; 7: 635637.CrossRefGoogle Scholar
Schmunis, GA. Epidemiology of Chagas disease in non-endemic countries: the role of international migration. Mem Ins Oswaldo Cruz 2007; 102 (Suppl 1): 7585.CrossRefGoogle ScholarPubMed
Altcheh, JM, Freilij, H. Chagas Disease: A Clinical Approach. Switzerland: Springer Nature, 2019.CrossRefGoogle Scholar
Basile, L, Jansa, JM, Carlier, Y, et al. Chagas disease in European countries: the challenge of a surveillance system. Euro Surveill 2011; 16(37): 19968. PMID: 21944556.CrossRefGoogle ScholarPubMed
Montgomery, SP, Starr, MC, Cantey, PT, et al. Neglected parasitic infections in the United States: Chagas disease. Am J Trop Med Hyg 2014; 90: 814818.CrossRefGoogle ScholarPubMed
Prata, A. Clinical and epidemiological aspects of Chagas disease. Lancet Infect Dis 2001; 1: 92100.CrossRefGoogle ScholarPubMed
Dávila, DF, Rossell, O, de Bellabarba, GA. Pathogenesis of chronic Chagas heart disease: parasite persistence and autoimmune responses versus cardiac remodelling and neurohormonal activation. Int J Parasitol 2002; 32: 107109.CrossRefGoogle ScholarPubMed
Bonney, KM, Engman, DM Chagas heart disease pathogenesis: one mechanism or many? Curr Mol Med 2008; 8: 510518.CrossRefGoogle ScholarPubMed
Rojas, LZ, Glisic, M, Pletsch-Borba, L, et al. Electrocardiographic abnormalities in Chagas disease in the general population: a systematic review and meta-analysis. PLoS Negl Trop Dis 2018; 12: e0006567.CrossRefGoogle ScholarPubMed
Marin-Neto, JA, Cunha-Neto, E, Maciel, BC, et al. Pathogenesis of chronic Chagas heart disease. Circulation 2007; 115: 11091123.CrossRefGoogle ScholarPubMed
Salazar-Schettino, PM, Cabrera-Bravo, M, Vazquez-Antona, C, et al. Chagas Disease in Mexico: report of 14 cases of chagasic cardiomyopathy in children. Tohoku J Exp Med 2016; 240: 243249.CrossRefGoogle ScholarPubMed
Geyer, H, Caracciolo, G, Abe, H, et al. Assessment of myocardial mechanics using speckle tracking echocardiography: fundamentals and clinical applications. J Am Soc Echocardiogr 2010; 23: 351369.CrossRefGoogle ScholarPubMed
Acquatella, H, Asch, F, Barbosa, M, et al. Recommendations for multimodality cardiac imaging in patients with Chagas disease: a report from the American Society of Echocardiography in Collaboration with the Inter American Association of Echocardiography (ECOSIAC) and the Cardiovascular Imaging Department of the Brazilian Society of Cardiology (DIC-SBC). J Am Soc Echocardiogr 2018; 31: 325.CrossRefGoogle Scholar
Zhang, L, Tarleton, RL. Parasite persistence correlates with disease severity and localization in chronic Chagas’ disease. J Infect Dis 1999; 180: 480486.CrossRefGoogle ScholarPubMed
Bland, JM, Altman, DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307310.CrossRefGoogle ScholarPubMed
Koopman, LP, Rebel, B, Gnanam, D, et al. Reference values for twodimensional myocardial strain echocardiography of the left ventricle in healthy children. Cardiol Young 2019; 29: 325337.CrossRefGoogle Scholar
Tarleton, RL, Zhang, L. Chagas disease etiology: autoimmunity or parasite persistence. Parasitol Today 1999; 15: 9499.CrossRefGoogle ScholarPubMed
De Oliveira, LF, Romano, MM, De Carvalho, EE, et al. Histopathological correlates of global and segmental left ventricular systolic dysfunction in experimental chronic Chagas cardiomyopathy. J Am Heart Assoc 2016; 5: e002786.CrossRefGoogle ScholarPubMed
Plana, JC, Galderisi, M, Barac, A, et al. Expert consensus for multimodality imaging evaluation of adult patients during and after cancer therapy: a report from the American society of echocardiography and the European association of cardiovascular imaging. J Am Soc Echocardiogr 2014; 27: 911939.CrossRefGoogle ScholarPubMed
Thavendiranathan, P, Poulin, F, Lim, KD, et al. Use of myocardial strain imaging by echocardiography for the early detection of cardiotoxicity in patients during and after cancer chemotherapy. J Am Coll Cardiol 2014; 63: 27512768.CrossRefGoogle ScholarPubMed
Levy, P, Machefsky, A, Sanchez, A, et al. Reference ranges of left ventricular strain measures by two dimensional speckle tracking echocardiography in children: systematic review and meta-analysis. J Am Soc Echocardiogr 2016; 29: 209225.CrossRefGoogle ScholarPubMed
Jashari, H, Rydberg, A, Ibrahimi, P, et al. Normal ranges of left ventricular strain in children: a meta-analysis. Cardiovasc Ultrasound 2015; 13: 37.CrossRefGoogle ScholarPubMed
Kuebler, JD, Ghelani, S, Williams, DM, et al. Normal values and growth-related changes of left ventricular volumes, stress, and strain in healthy children measured by 3-dimensional echocardiography. Am J Cardiol 2018; 122: 331339.CrossRefGoogle ScholarPubMed
Cui, W, Roberson, DA. Left ventricular Tei Index in children: comparison of tissue doppler imaging, pulsed wave Doppler, and m-mode echocardiography normal values. J Am Soc Echocardiogr 2006; 19: 14381445.CrossRefGoogle ScholarPubMed
Ferferieva, V, Van den Bergh, A, Claus, P, et al. The relative value of strain and strain rate for defining intrinsic myocardial function. Am J Physiol Heart Circ Physiol 2012; 302: H188H195.CrossRefGoogle ScholarPubMed
Da Cunha, A, Daud, W, Rimmel, AG, et al. Cardiopatia chagásica crônica causando Insuficiência cardíaca congestiva na infância:Estudo clínico e histopatológico de um caso, Com ênfase para as lesões dos sistemas excitocondutor e nervoso autônomo intracardíaco. Rev Soc Bras Med Trop 1993; 26: 243249.Google Scholar
de Araujo, RC, Bessetti, RB, Godoy, RA, Oliveira, JS. Chronic Chagas’ heart disease in children and adolescents: a clinicopathologic study. Int J Cardiol 1985; 9: 439449.CrossRefGoogle Scholar
Krell, K, Laser, KT, Dalla-Pozza, R, et al. Real-Time three-dimensional echocardiography of the left ventricle-pediatric percentiles and head-to-head comparison of different contour-finding algorithms: a multicenter study. J Am Soc Echocardiogr 2018; 31: 702711.CrossRefGoogle ScholarPubMed
Buccheri, S, Costanzo, L, Tamburino, C, et al. Reference values for real time three-dimensional echocardiography-derived left ventricular volumes and ejection fraction: review and meta-analysis of currently available studies. Echocardiography 2015; 32: 18411850.CrossRefGoogle ScholarPubMed