[Left ventricular mechanics in Chagas' disease and primary dilated myocardiopathies. A hemodynamic study].
The evolution of several mechanical parameters of left ventricular function was studied in 32 control subjects, 171 chronic chagasic and 60 primary dilated cardiomyopathy patients, which were submitted to an extensive invasive and non-invasive protocol. Preload and afterload (end-diastolic and end-systolic stress), contractile status (ejection fraction), the magnitude (mass/index) and adequacy of hypertrophy (mass/volume ratio) and afterload (systolic stress/volume ratio) were derived from the invasive explorations. There was an increased afterload in 25% of chronic chagasic patients without other evidence of early myocardial damage, which was accompanied by signs of inadequate hypertrophy. Both findings increased further with the progression of the disease. Systolic performance was initially preserved, but showed a progressive depression paralleling the clinical evolution. Patients with dilated cardiomyopathy showed a mechanical profile similar to chagasic patients with advanced degree of myocardial damage. The hemodynamic determination of mass index, mass/volume ratio, end-systolic and end-diastolic stress seem to be the best parameters for detection of early abnormalities in loading conditions of the heart in chronic Chagas, disease, and for indication and evaluation of the results of vasodilator therapy in both groups of patients.
Gómez de Pereira
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C
Centro Cardiovascular Dr. Abdel M. Fuenmayor, Universidad de los Andes, Mérida, Venezuela.
Carrasco
H A
HA
Guerrero
L
L
Parada
H
H
Molina
C
C
Chuecos
R
R
D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000503:physiopathology*; D002598:Chagas Cardiomyopathy / Q000503:physiopathology*; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000503:physiopathology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016277:Ventricular Function, Left / Q000502:physiology*
Mecánica ventricular izquierda en la enfermedad de Chagas y las miocardiopatías dilatadas primarias. Estudio hemodinámico.