title: Early right cardiac dysfunction in patients with schistosomiasis mansoni.
abstract: BACKGROUND
  Pulmonary hypertension (PH) is a complication of schistosomiasis mansoni (SM), mainly in the hepatosplenic form. However, its prevalence is not well established. We evaluated the usefulness of Doppler echocardiographic indexes to detect right heart dysfunction in SM.
  
  
  METHODS
  A total of 83 patients divided into two groups were studied: Group 1: 44 patients with hepatosplenic SM, and Group 2: 39 patients with hepatointestinal SM who served as controls. All patients underwent a Doppler echocardiogram. Right ventricular end-diastolic area (RVEDA), the peak systolic tricuspid annular tissue velocity (S'), right ventricular index of myocardial performance (RVIMP) and right atrial area (RAA) were measured in all patients. Tricuspid regurgitation peak velocity (TR) was measured and the pressure gradient (TG) was obtained.
  
  
  RESULTS
  The prevalence of patients with elevated systolic pulmonary artery pressure at echocardiography was 31% in hepatosplenic patients, while no patient with the hepatointestinal form presented PH. Patients with hepatosplenic SM had larger RVEDA (10.0 ± 2.8 vs. 8.5 ± 1.8 cm(2) /m, P = 0.006) and RAA (9.39 [8.3-11.0] vs. 7.7 [6.9-8.4 cm(2) /m], P < 0.001). There was correlation between TG and RVIMP (r = 0.58; P < 0.001) and between TG and RAA (r = 0.36; P = 0.03) in Group 1.
  
  
  CONCLUSIONS
  Larger RAA and RVEDA were found in patients with hepatosplenic SM, when compared to patients with the hepatointestinal form, which may suggest early impairment of RV function in patients with hepatosplenic SM.
authors.affiliation: Post Graduation Course of Tropical Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil ECOCENTER, Hospital Socor, Belo Horizonte, MG, Brazil. v-tostes@uol.com.br
authors.forename: Vinicius T
authors.initials: VT
authors.lastname: Carvalho
authors.forename: Marcia M
authors.initials: MM
authors.lastname: Barbosa
authors.forename: Maria Carmo P
authors.initials: MC
authors.lastname: Nunes
authors.forename: Yuri S
authors.initials: YS
authors.lastname: Cardoso
authors.forename: Isaías M
authors.initials: IM
authors.lastname: de Sá Filho
authors.forename: Flávia R
authors.initials: FR
authors.lastname: Oliveira
authors.forename: Carlos Maurício F
authors.initials: CM
authors.lastname: Antunes
authors.forename: José R
authors.initials: JR
authors.lastname: Lambertucci
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D015897:Comorbidity; D004452:Echocardiography / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012555:Schistosomiasis mansoni / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D012680:Sensitivity and Specificity; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000453:epidemiology*