Echocardiographic parameters associated with pulmonary congestion in Chagas cardiomyopathy.
BACKGROUND
Discrepancy between the intensity of pulmonary congestion and the grade of cardiomegaly seems to be a common finding of Chagas cardiomyopathy, in spite of significant systolic dysfunction of the left ventricle. Its mechanism has not been established. The aim of this study was to investigate pulmonary congestion and to analyze if it correlated with Doppler echocardiographic parameters in patients with Chagas dilated cardiomyopathy.


METHODS
Fifty-five patients with positive serology tests for Trypanosoma cruzi and Chagas dilated cardiomyopathy were studied. Chest x-rays, Doppler echocardiogram and plasmatic brain natriuretic peptide levels were obtained in all patients. The degree of pulmonary venous vessels changes on chest x-ray was graded using a pulmonary congestion score, and then compared to Doppler echocardiographic parameters.


RESULTS
Mean age was 48.5 +/- 11.2 years and 29% were women. The majority (95%) of patients were in NYHA functional class I and II. Mild pulmonary congestion by chest x-ray was found in 80% of the patients. In a multivariate analysis, left ventricular ejection fraction, right ventricular TEI index and the color M-mode velocity correlated with the degree of pulmonary congestion.


CONCLUSIONS
Pulmonary venous changes on chest x-rays are frequent, but usually mild in patients with Chagas dilated cardiomyopathy. The degree of pulmonary congestion correlates with Doppler echocardiographic left and right ventricular dysfunction and with color M-mode velocity.
Barral
Marselha Marques
MM
Postgraduate Course of Infectious Diseases and Tropical Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil. mbarral@terra.com.br
Nunes
Maria Carmo Pereira
MC
Barbosa
Marcia Melo
MM
Ferreira
Cid Sérgio
CS
Tavares Júnior
Wilson Campos
WC
Rocha
Manoel Otávio da Costa
MO
D002598:Chagas Cardiomyopathy / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011654:Pulmonary Edema / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D011859:Radiography; D012720:Severity of Illness Index; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000000981:diagnostic imaging; D018497:Ventricular Dysfunction, Right / Q000150:complications* / Q000000981:diagnostic imaging
D020097:Natriuretic Peptide, Brain