Cardiac magnetic resonance in Chagas' disease.
American trypanosomiasis (Chagas' disease [CD]) caused by Trypanosoma cruzi is endemic in Latin America, where it is one of the leading causes of death. The involvement of the heart is crucial in the patients' prognosis. Besides lymphocytic myocarditis, cardiomyopathy is associated with several degrees of myocardial fibrosis (MF). Myocardial delayed enhancement by cardiac magnetic resonance (CMR) has been considered the most accurate method to detect MF in ischemic and nonischemic cardiomyopathy, including Chagas' heart disease. Additionally, CMR offers a wide variety of imaging tools to evaluate in detail morphology, the function and other tissue characterization abilities, such as detection of edema and fat. The present article aims to discuss the current clinical applicability of CMR to evaluate CD. We also discuss its future as a screening tool for very early myocardial involvement, which would allow the investigation of new therapeutic methods with potential influence in the natural history of CD.
Rochitte
Carlos Eduardo
CE
Cardiology Department of Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil. rochitte@incor.usp.br
Nacif
Marcelo Souto
MS
de Oliveira Júnior
Amarino Carvalho
AC
Siqueira-Batista
Rodrigo
R
Marchiori
Edson
E
Uellendahl
Marly
M
de Lourdes Higuchi
Maria
M
D002598:Chagas Cardiomyopathy / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D005355:Fibrosis / Q000469:parasitology / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008403:Mass Screening / Q000379:methods; D009206:Myocardium / Q000473:pathology*; D011379:Prognosis