title: Echocardiographic parameters associated with pulmonary congestion in outpatients with Chagas' cardiomyopathy and non-chagasic cardiomyopathy.
abstract: Despite significant left ventricular (LV) systolic dysfunction and cardiomegaly, pulmonary congestion does not seem to be a major finding in Chagas' cardiomyopathy (CC). This study sought to identify echocardiographic parameters associated with pulmonary congestion in CC and in dilated cardiomyopathy of other etiologies, such as non-CC (NCC), and to compare pulmonary venous hypertension between the two entities.
  
  
  
  A total of 130 consecutive patients with CC and NCC, with similar echocardiographic characteristics, were assessed using Doppler echocardiography and chest radiography. Pulmonary venous vessel abnormalities were graded using a previously described pulmonary congestion score, and this score was compared with Doppler echocardiographic parameters.
  
  
  
  NCC patients were older than CC patients (62.4 ± 13.5 × 47.8 ± 11.2, p = 0.00), and there were more male subjects in the CC group (66.2% × 58.5%, p = 0.4). Pulmonary venous hypertension was present in 41 patients in the CC group (63.1%) and in 63 (96.9%) in the NCC group (p = 0.0), the mean lung congestion score being 3.2 ± 2.3 and 5.9 ± 2.6 (p = 0.0), respectively. On linear regression multivariate analysis, the E/e' ratio (β = 0.13; p = 0.0), LV diastolic diameter (β = 0.06; p = 0.06), left atrial diameter (β = 0.51; p = 0.08), and right ventricular (RV) end-diastolic diameter (β = 0.02; p = 0.48) were the variables that correlated with pulmonary congestion in both groups.
  
  
  
  Pulmonary congestion was less significant in patients with CC. The degree of LV of systolic and diastolic dysfunction and the RV diameter correlated with pulmonary congestion in both groups. The E/e' ratio was the hallmark of pulmonary congestion in both groups.
authors.affiliation: Programa de Pós-graduação em Doenças Infecciosas e Medicina Tropical, Universidade Federal de Minas Gerais, Belo Horizonte, MG. mbarral@terra.com.br
authors.forename: Marselha Marques
authors.initials: MM
authors.lastname: Barral
authors.forename: Maria do Carmo Pereira
authors.initials: Mdo C
authors.lastname: Nunes
authors.forename: Marcia Melo
authors.initials: MM
authors.lastname: Barbosa
authors.forename: Cid Sérgio
authors.initials: CS
authors.lastname: Ferreira
authors.forename: Wilson Campos
authors.initials: WC
authors.lastname: Tavares
authors.forename: Manoel Otávio da Costa
authors.initials: MO
authors.lastname: Rocha
mesh_terms: D009202:Cardiomyopathies / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D002598:Chagas Cardiomyopathy / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011654:Pulmonary Edema / Q000209:etiology* / Q000503:physiopathology; D012720:Severity of Illness Index